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

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