Document Type
Article
Publication Date
10-1-2021
Publication Title
Cureus
ISSN
2168-8184
Department(s)
Department of Surgery; Fellows and Residents; USF-LVHN SELECT Program Students
Keywords
instillation, mepitel, negative pressure wound therapy, pyoderma gangrenosum, rheumatoid arthritis
Abstract
Pyoderma gangrenosum (PG) is a rare skin disorder primarily treated with immunosuppression medication. We report a case of a large, chronic PG wound treated with adjunct negative pressure wound therapy with instillation and dwell time (NPWTi-d) using nonadherent dressing (Mepitel) and reticular open-cell foam with through holes (ROCF-CC) with positive outcomes. The patient was a 62-year-old female with rheumatoid arthritis, Hashimoto's thyroiditis, lymphedema, and morbid obesity who presented with a 19.5 cm x 13.2 cm x 2.1 cm wound of three years duration on the right posterolateral lower extremity that successfully responded to a multimodality approach of immunosuppression and wound vac therapy. We conclude in our case that NPWTi-d with Mepitel and ROCF-CC enhanced the wound healing process, and we discuss NPWTi-d's potential role and benefit as an adjunctive therapy option for chronic and poorly controlled PG on patients taking concurrent immunosuppression.
Volume
13
Issue
10
First Page
e18951
DOI
10.7759/cureus.18951
PubMed ID
34815898
Recommended Citation
Lee, F. G., Song, E., Wallace, S. J., Shaughnessy, T. J., Raj, M., Teixeira, R., Miles, M. G., & Wojcik, R. (2021). Non-surgical Management of Complex Refractory Pyoderma Gangrenosum With Negative Pressure Wound Therapy With Instillation. LVHN Scholarly Works. Retrieved from https://scholarlyworks.lvhn.org/research-historical-works/23
DOI: 10.7759/cureus.18951
Comments
Oral presentation at Schaeffer Research Day in Allentown, PA, May 2021.