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Case Study on Management of Postsurgical Pyoderma Gangrenosum After Spinal Surgery

Ratliff, Catherine R.

Journal of Wound, Ostomy and Continence Nursing: November/December 2019 - Volume 46 - Issue 6 - p 543–546
doi: 10.1097/WON.0000000000000587
Challenges in Practice
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BACKGROUND: Postsurgical pyoderma gangrenosum (PSPG) is a rare autoimmune, neutrophilic dermatosis that results with the occurrence of pyoderma gangrenosum (PG) within surgical incisions. Presenting symptoms include erythema and pain at the surgical incision with wound dehiscence. The clinical appearance of the PSPG wound (similar to PG) shows raised with dusky red or violaceous (violet-colored) wound edges and undermining with little or no evidence of granulation tissue. “Pathergy” is the term used to describe worsening of the wound in response to trauma such as debridement. Postsurgical pyoderma gangrenosum should be suspected in postoperative wounds, which continue to become progressively worse despite broad-spectrum antibiotics, good wound care, and surgical debridement.

CASE: A clinical case study of a patient with PSPG from spine surgery is described.

CONCLUSION: Postsurgical pyoderma gangrenosum should be suspected in postoperative wounds, which continue to become progressively worse despite broad-spectrum antibiotics, good wound care, and surgical debridement.

Catherine R. Ratliff, PhD, GNP-BC, CWOCN, CFCN, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Virginia Health System, Charlottesville.

Correspondence: Catherine R. Ratliff, PhD, GNP-BC, CWOCN, CFCN, Division of Vascular and Endovascular Surgery, Department of Surgery, University of Virginia Health System, Box 801351, Charlottesville, VA 22908 (Crr9m@virginia.edu).

The author declares no conflicts of interest.

© 2019 by the Wound, Ostomy and Continence Nurses Society.