Pyoderma gangrenosum after orthopaedic or traumatologic surgery: a systematic revue of the literature

Ebrad, Stephan; Severyns, Mathieu; Benzakour, Ahmed; Rozé, B.; Derancourt, Christian; Odri, G.; Rouvillain, J.-L.

doi:10.1007/s00264-017-3672-2

Cited by 16 publications

(16 citation statements)

References 64 publications

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“…The disease can be categorised into several variants: classic, bullous, pustular, vegetative, drug induced, postsurgical and peristomal 2. Postsurgical pyoderma gangrenosum presents at the surgical site most commonly after breast, chest, cardiothoracic or orthopaedic surgery 2 6. However, reports of occurrence of pyoderma gangrenosum after caesarean sections are very sparse.…”

Section: Discussionmentioning

confidence: 99%

Challenge of diagnosing pyoderma gangrenosum after caesarean section

et al. 2019

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Pyoderma gangrenosum is a neutrophilic skin disease that leads to extensive, painful, necrotic ulcerations, particularly at surgical sites. As obstetric cases with pyoderma gangrenosum are rare and, therefore, often misdiagnosed initially, it is important to raise awareness about this rare complication. Here, we describe a patient who presented with pyoderma gangrenosum at the surgical site 4 days after undergoing a caesarean section. The erythema was initially misdiagnosed as wound infection, and the patient, who was experiencing pain, underwent antibiotic treatment and surgical wound debridement. When the wound was unresponsive to these treatments, a dermatologist was consulted who suspected pyoderma gangrenosum and began a high-dose corticosteroids therapy, which led to a fulminant improvement of the local wound. In conclusion, the rare diagnosis of pyoderma gangrenosum should be considered in the differential diagnosis of a suspected surgical wound infection. Early interdisciplinary treatment is essential to avoid further complications.

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Section: Discussionmentioning

confidence: 99%

Challenge of diagnosing pyoderma gangrenosum after caesarean section

et al. 2019

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“…Overall, these lesions are most common in the lower extremities but postoperatively are more likely to involve the breast or abdomen [ 7 , 9 ]. Owing to its clinical appearance and correlation to surgical intervention, it is commonly misdiagnosed as postoperative wound infection or necrotizing fasciitis, leading to 73% patients being treated with wound debridement and 90% with empiric antibiotic therapy [ 9 , 10 ]. In this case report, we discuss a case of a man with postoperative PG after bilateral total knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

Pyoderma Gangrenosum After Bilateral Total Knee Arthroplasty

Loomis¹,

Merrit

Aleshin

et al. 2021

Arthroplasty Today

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“…The pathergy phenomenon describes the development of additional lesions or progression of existing ones during active PG when skin integrity is interrupted [4]. It has been reported to occur at sites of intravenous lines, injections, and surgical wounds [5]. Pathergy puts the patient at risk for complications, resulting in recommendations not to perform any surgery on PG lesions; other authors recommend surgical management of PG ulcers in a less active period of the disease [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Hemiarthroplasty in a patient with femoral neck fracture and pyoderma gangrenosum: a case report and review of the literature

et al. 2020

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Background: Pyoderma gangrenosum is a rare ulcerating skin disease of unknown etiology, making its coincidence with orthopedic trauma a rare challenge. Patients are at risk of progression of the existing lesions and development of new lesions upon skin injury when surgical procedures are performed. To our knowledge, this is the first report in the literature of disease unrelated surgery during active pyoderma gangrenosum. Case presentation: We present a case of femoral neck fracture in a Caucasian patient with concurrent pyoderma gangrenosum localized in the axilla. Hemiarthroplasty was safely performed after disease activity was reduced with systemic corticosteroids. Tissue-protective wound closure was used together with perioperative corticosteroids and antibiotics. No signs of pyoderma gangrenosum developed at the surgical wound site, and the axillary lesions showed constant improvement until healing with scar tissue. Conclusions: In our patient, the preoperative steroid treatment, perioperative antibiotics, and soft tissue protective surgical technique led to successful management of this rare coincidence.

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Pyoderma gangrenosum after orthopaedic or traumatologic surgery: a systematic revue of the literature

Abstract: IV: Systematic revue of the literature.

Cited by 16 publications

References 64 publications

Challenge of diagnosing pyoderma gangrenosum after caesarean section

Challenge of diagnosing pyoderma gangrenosum after caesarean section

Pyoderma Gangrenosum After Bilateral Total Knee Arthroplasty

Hemiarthroplasty in a patient with femoral neck fracture and pyoderma gangrenosum: a case report and review of the literature

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