Pyoderma gangrenosum complicating Caesarian section

Pyoderma gangrenosum and pregnancy: an example of abnormal inflammation and challenging treatment

“…Pathergy may have been involved in the development of PG in several of the reviewed clinical cases. Eleven reports described women aged 24–43 years who developed PG at the site of caesarean incision 1 day to 4 weeks after delivery …”

“…Eleven reports described women aged 24-43 years who developed PG at the site of caesarean incision 1 day to 4 weeks after delivery. 30,33,[39][40][41][42][44][45][46][47][48] Thirteen reports also documented PG lesions occurring in locations that are often associated with trauma and bruising, such as the arms, legs and feet. 28,29,31,[34][35][36][43][44][45][49][50][51][52] Notably, two of these patients also developed PG lesions at the site of caesarean sections as described above.…”

“…43 Wound-care techniques included daily dressings with saline, Betadine and metronidazole, 41 treatment of wound edges with tacrolimus 39 and the use of vacuum-assisted closure. 46 Surgical debridement at some point during the course of the patients' disease 32,42,45,52 and skin grafting 32,46,48,52 were involved in five and four cases, respectively.…”

“…A review of more than 350 published cases suggested that systemic therapy should be considered first-line therapy for disseminated PG, with topical therapy being directed to avoid secondary wound infections. 90 Twenty-two reports of patients with PG and pregnancy described the use of any form of systemic corticosteroids, [28][29][30][31][32][33][34][35][39][40][41][42][43][44][45][46]48,50,[52][53][54] such as prednisone, prednisolone or methylprednisolone. Systemic corticosteroids are common first-line therapy in patients with PG, and based on our report they have been successfully used in patients with PG during pregnancy and puerperium.…”

Management of a chronic wound secondary to pyoderma gangrenosum following uncomplicated lower segment Caesarean section incision

“…Reports of pyoderma gangrenosum complicating surgical incisions are rare and include plastic surgery of the breast in reduction mammoplasty, 1,3 cholecystectomy, 4 transabdominal preperitoneal hernioplasty, 2 abdominal stoma surgery/colectomy in patients with Crohn's disease, 5 hip joint surgery, 6 orthopaedic surgery involving the extremities, 7 leg amputation 8 and coronary artery bypass grafting 9 . We present our management of a rare case involving pyoderma gangrenosum following lower uterine segment Caesarean section incision, one of only a few other similar cases, 10–12 and review other reports in the literature.…”