Pyoderma Gangrenosum: A Novel Wound Closure Approach using an Autologous Skin Cell Suspension with a Wide Meshed Autograft-A Four Year Experience

Introduction: Treatment of Pyoderma Gangrenosum is aimed at controlling inflammation, while promoting wound healing and preventing complications. Treatment includes topical, systemic and surgical treatments.Surgical intervention is controversial as it can lead to lather by-the worsening of skin injury after manipulation of the primary lesion, however some surgical interventions when combined with a pharmacological approach have been shown to reduce wound size.Methods:Patients were seen by a multidisciplinary team, placed on immunosuppressive medications and once patients had achieved quiescence, they were treated surgically using autologous skin cell suspension and followed overa period of two years.Results:A total of four patients diagnosed with pyoderma gangrenosum underwent surgical treatment with wide mesh and autologous aerosolized skin graft were included. The average age was 57.5 +/- 18 years old, venous insufficiency, TIIDM and HTN were the most common comirbidities and the average non-healing time of those wounds was 36 +/- 12 months. All patients achieved full closure by day 45.Discussion: Surgical treatment of pyoderma gangrenosum in combination with immunosuppression is supported by published data. However, it remains controversial due to the concern of surgery-induced lather by and should be considered on a case-by-case basis. The use of widely meshed skin graft and autologous skin cell suspension shows promise in the treatment of wound ulcers related to pyoderma gangrenosum and further studies with a larger number of patients are needed to evaluate long term results.References: