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Plastic and Reconstructive Surgery - Global Open:
doi: 10.1097/GOX.0000000000000114
Case Reports

Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

Berlinrut, Ilan MD*†; Bhatia, Nitasha MD*†; Josse, Jonathan M. MD, MSc†§; de Vinck, David DO‡§; Kaul, Sanjeev MD†§

Open Access
United States
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Abstract

Summary: Pyoderma gangrenosum (PG) is an inflammatory disease characterized by sterile infiltration of the skin by neutrophils. We describe a case of a 63-year-old woman who developed PG following an abdominal wall reconstruction. Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue. Wound cultures remained negative, and maximal antibiotic coverage did not halt tissue breakdown. A trial of steroids was initiated, and the patient’s condition subsequently improved. Tissue biopsy results were compatible with the diagnosis of PG.

© 2014 American Society of Plastic Surgeons