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The role of negative pressure wound therapy (<scp>NPWT</scp>) on the treatment of pyoderma gangrenosum: A systematic review and personal experience

Authors :
Henrique Ovidio Coraspe Gonçalves
Andrezza Telles Westin
Jayme Adriano Farina Júnior
Renan Victor Kümpel Schmidt Lima
Marcelo Filadelfo Silva
Ivan Almeida
Pedro Soler Coltro
Juliano Baron Almeida
Source :
Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP
Publication Year :
2021
Publisher :
Wiley, 2021.

Abstract

Pyoderma gangrenosum (PG) is a rare painful ulcerative neutrophilic inflammatory skin disease, necessitating a high level of diagnostic suspicion associated with appropriate treatment to avoid progression. Negative pressure wound therapy (NPWT) has been efficiently used in the treatment of different types of wounds. However, the role of NPWT in the management of PG is still controversial, due to the risk of the pathergy phenomenon. In this article, we conducted a systematic review (according to the PRISMA guidelines) on the use of NPWT in the treatment of PG, and we report our personal experience with two patients treated with this device. The result of the review showed that articles on the topic are, in their entirety, of low levels of evidence, such as case series, case reports, and reviews. Improvement in wound healing with the use of NPWT was observed in 85.1% of the patients studied. Besides, a significant association between improvement in wound healing with NPWT and immunosuppressive therapy was observed. Regarding the cases reported here, both showed good outcomes with the use of NPWT and skin graft during the treatment of PG injuries. Due to the rarity of PG, there is a scarcity of studies with robust evidence for standardization and comparison between treatments, which consequently makes it difficult to select therapeutic options. However, based on this systematic review and reported cases, we consider NPWT a safe option for adjuvant treatment of wounds caused by PG if combined with systemic immunosuppression, which plays a key role in greater chances of successful treatment. This approach should be recommended, whenever possible, associated with skin grafting to accelerate wound closure. The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: a systematic review and personal experience.

Details

ISSN :
1524475X and 10671927
Volume :
29
Database :
OpenAIRE
Journal :
Wound Repair and Regeneration
Accession number :
edsair.doi.dedup.....16eaa684ca5ce62ac88c3bf42e49f1ce
Full Text :
https://doi.org/10.1111/wrr.12910