Non-surgical Management of Complex Refractory Pyoderma Gangrenosum With Negative Pressure Wound Therapy With Instillation.

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.

• Authors: Frank G Lee, Ethan Song, Sean J Wallace, Thomas J Shaughnessy, Mamtha Raj, Robert Teixeira, Marshall G Miles, Randolph Wojcik Jr
• Journal: Cureus (Cureus) Vol. 13 Issue 10 Pg. e18951 (Oct 2021) ISSN: 2168-8184 [Print] United States
• PMID: 34815898 (Publication Type: Case Reports)
• Copyright: Copyright © 2021, Lee et al.