Managing Pyoderma Gangrenosum: A Synergistic Approach Combining Surgical D??bridement, Vacuum-Assisted Closure, and Hyperbaric Oxygen Therapy

Experiencia en la utilización del sistema de terapia de presión negativa Renasys® en el Hospital La Fe, Valencia. España

“…El tratamiento quirúrgico es controvertido pues se han descrito casos en los que la necrosis puede progresar. Niezgoda et al (21) exponen que el tratamiento con oxígeno hiperbárico y terapia de vacío tiene un efecto sinérgico en la mejora del aporte sanguíneo a la lesión y que, por ende, acelera la curación. Para la cobertura de defectos craneales se pueden usar desde injertos (con pobres resultados estéticos) a colgajos locales o a distancia, dependiendo de los tejidos que se encuentren en el lecho de la herida.…”

Pyoderma gangrenosum: A case report of bilateral dorsal hand lesions and literature review of management

“…Early reports centred treatment on halting wound progression with systemic, intralesional and topical corticosteroids (14). Cyclosporine and other immunosuppressive agents, such as topical nitrogen mustard, certain antimicrobial agents, clofazimine and dapsone, which are typically used in the treatment of leprosy, evolved as adjunctive measures (1,14,15). The other mainstay of treatment involved the avoidance of surgical intervention including debridement and skin grafting, which, as alluded to previously, may result in pathergy.…”

“…Hypothesized to be of immunological etiology, conservative treatment using prolonged high-dose systemic corticosteroids and other immunosuppressants, in addition to gentle local wound care, characterizes the mainstay of management. Failure of these traditional treatment modalities has prompted the use of more advanced interventions such as negative-pressure wound dressings and hyperbaric oxygen (HBO) therapy, with documented success (1)(2)(3)(4). Here, we present an interesting case of temporally distinct PG lesions on the dorsal aspect of the hands, initially believed to be necrotizing infection, unintentionally but successfully treated with a combination of HBO therapy and negative-pressure vacuum-assisted closure.…”

“…HBO therapy is gaining acceptance as an effective adjunctive measure in enhancing both the quality and timeline of wound healing (1)(2)(3)(4). It has been found to successfully stabilize progressive necrotizing wounds while also decreasing infection rates.…”

Pyoderma Gangrenosum and Surgery: Case Report

“…Bu uygulama ile 24-48 saat içerisinde hastalık progresyonu durdurulabilir. 15 İyileşme, yara kenarında epitelizasyonla başlar. Eritemli ve endüre yara kenarları düzleş-meye başladığında ve ağrı azaldığında antiinflamatuar tedavi dozu azaltılmaya başlanabilir.…”