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Resurfacing wounds of pyoderma gangrenosum- A surgeon’s nightmare effective interdepartmental communication is the key to success

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Original Article

Author Details : Narendra S.Mashalkar*

Volume : 1, Issue : 2, Year : 2019

Article Page : 37-39

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Abstract

Introduction: Patients with wounds come in varied forms to a plastic surgeon. Usually chronic wounds which are recalcitrant to conservative treatment require surgical management in the form of resurfacing. All recalcitrant wounds need to be seen with suspicion to identify the underlying systemic disease activity. It is tempting for the plastic surgeon to auto graft each chronic wound as early as possible.
This is how a night mare begins. This paper is written with the intention of not hurriedly taking up every chronic wound for resurfacing without properly evaluating the patient and how effective communication with a dermatology colleague will go a long way in benefiting the pt.
Aims and objective: 1. To discuss our experience of treating three cases of chronic wounds of P.G and the course and events occurring in each chronic wound till ultimate healing of the wounds. 2. The lessons we learnt during each course.
Materials and Methods: A detailed description of course of hospital stay of three cases of P.G with description of interdepartmental discussion and review of literature specifically for surgical management of such wounds.
Results: Three cases of chronic wounds of which one had active disease healed with conservative mx and the second case in which the disease became quiescent, a pathergy graft test was done, which eventually had no consequences, later a formal ssg was done with no complications. The third case developed new wounds at surgical sites and conservative management was applied.
Conclusion: Lessons learnt; 1. Grafting wounds in cases of chronic wounds with P.G needs to be proceeded with extreme caution.  2. Pathergy test ssg to see for flare ups and to proceed when the disease is quiescent or in inactive phase.  3. Interdepartmental communication is very necessary in such cases.

Keywords: Split skin grafting, Pathergy test, Conservative.

How to cite : S.mashalkar N, Resurfacing wounds of pyoderma gangrenosum- A surgeon’s nightmare effective interdepartmental communication is the key to success. IP J Surg Allied Sci 2019;1(2):37-39

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