論文

国際誌
2022年2月

Pyoderma Gangrenosum after Breast Cancer Resection: A Less-invasive and Early Treatment Using the Skin around Ulcers.

Plastic and reconstructive surgery. Global open
  • Kotaro Hirai
  • ,
  • Itaru Tsuge
  • ,
  • Shunya Usui
  • ,
  • Masahiro Takada
  • ,
  • Hiroki Yamanaka
  • ,
  • Motoki Katsube
  • ,
  • Michiharu Sakamoto
  • ,
  • Naoki Morimoto

10
2
開始ページ
e4111
終了ページ
記述言語
英語
掲載種別
DOI
10.1097/GOX.0000000000004111

Surgical invasion is a risk factor of pyoderma gangrenosum (PG). A total of 25% of postoperative PG cases were reported to occur after breast surgeries, including bilateral breast reduction and breast reconstruction following cancer resection. Immunosuppressive therapy and less-invasive wound therapy are necessary; however, the complete healing of ulcers takes 5.1 months on average. We herein report a case of skin grafting under a surgical concept of less-invasive and short-term treatment. An 82-year-old woman complained of a high fever and severe pain at her breast wounds after bilateral breast cancer resection. Although we performed emergency debridement surgery to remove the necrotic tissue, suspecting surgical site infection and inflammation, her high fever persisted. She was diagnosed with PG because of the physical findings of characteristic painful, sterile ulcerations, bullae and pustules, and the pathological abundance of neutrophils in the absence of infection and vasculitis. Oral administration of prednisolone 30 mg/day improved the symptoms, and we applied negative-pressure wound therapy (NPWT) from day 16 following debridement surgery. After the gradual reduction of oral steroid intake to 12.5 mg/day, we performed skin grafting surgery. To limit the surgical invasion, we used the surplus skin around the ulcers. Split-thickness mesh skin grafts were fixed by NPWT to avoid the use of tie-over sutures. We achieved short-term treatment of PG with a less-invasive surgical strategy using skin around the ulcers and NPWT.

リンク情報
DOI
https://doi.org/10.1097/GOX.0000000000004111
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/35186644
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8846357
ID情報
  • DOI : 10.1097/GOX.0000000000004111
  • PubMed ID : 35186644
  • PubMed Central 記事ID : PMC8846357

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