Title: Case Series of Pyoderma Gangrenosum Successfully Managed with Biological Dressing

Authors: Prakash D, Prasad PVS, Kaviarasan PK, Baskaran VR, Kannambal K

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.198

Abstract

Introduction: The management of recalcitrant vasculitic ulcers of pyoderma gangrenosum (PG) still lacks an ideal challenging topical agent which promotes optimum healing with negligible side effects. Current scenario of management depends on steroids and other immunosuppressive agents which are more devastating than the disease itself. Conventional treatment such as relief of pressure, wound debridement, local dressing, antibiotic therapy, skin grafting, and supportive therapy are somewhat effective in the treatment of such non-healing wounds. Biological dressings are the ideal dressing for the management of chronic wounds. The newer biological dressings like collagen and growth factors, targets the specific defects in the chronic ulcer environment. Collagen is a natural biological skin substitute, easily available, ready to use, non-antigenic, and non-pyrogenic. Collagen induced healing involve all three phases of the natural wound-healing cascade. Collagen sheets are derived from tissues of bovine, avian, porcine and fish origin, which comprises type I and III collagen.

Case Report: We have treated five cases of chronic non-healing leg ulcers of PG with oral dapsone and corticosteroids, in combination with topical wet collagen sheet dressings. In all patients of PG included in our study, the ulcers healed completely within duration of 8 to 10 weeks.

Conclusion: This study is being presented to highlight the superior efficacy of biological dressings in chronic vasculitic ulcers of pyoderma gangrenosum.

Keywords: Pyoderma gangrenosum (PG), Biological dressing, Wet collagen sheet, Chronic non-healing leg ulcer.

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