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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
- 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.
- Subjects :
- medicine.medical_specialty
Systemic immunosuppression
medicine.medical_treatment
Dermatology
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Negative-pressure wound therapy
FERIMENTOS E LESÕES
Humans
Medicine
Intensive care medicine
Skin
Wound Healing
integumentary system
business.industry
Inflammatory skin disease
Skin Transplantation
Evidence-based medicine
medicine.disease
Pyoderma Gangrenosum
Pathergy
Skin grafting
Surgery
business
Wound healing
Negative-Pressure Wound Therapy
Pyoderma gangrenosum
Subjects
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