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Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage.

Cicuto B, Cheriyan T, Rudnicki P, Guo L - Plast Reconstr Surg Glob Open (2015)

Bottom Line: All three received systemic corticosteroid treatment, resulting in resolution of symptoms.As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction.This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Lahey Hospital and Medical Center, Tufts University, School of Medicine, Boston, Mass.

ABSTRACT
We report 3 cases of breast pyoderma gangrenosum in patients undergoing total mastectomy with immediate reconstruction. All three received systemic corticosteroid treatment, resulting in resolution of symptoms. As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction. This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition.

No MeSH data available.


Related in: MedlinePlus

Ulcerations seen on POD 10. On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain in place.
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Figure 2: Ulcerations seen on POD 10. On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain in place.

Mentions: She also had skin debridement on POD 10 (Fig. 2). On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain (Cardinal Health, Dublin, Ohio) in place. Histology of the dermal ulcerative speci men was consistent with the clinical diagnosis of PG (Fig. 3). No bacterial growth was found in specimens.


Post Reconstruction Breast Pyoderma Gangrenosum: Early Recognition and Prosthesis Salvage.

Cicuto B, Cheriyan T, Rudnicki P, Guo L - Plast Reconstr Surg Glob Open (2015)

Ulcerations seen on POD 10. On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain in place.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494504&req=5

Figure 2: Ulcerations seen on POD 10. On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain in place.
Mentions: She also had skin debridement on POD 10 (Fig. 2). On exploration, suture line skin edge necrosis was resected along with the surrounding ulcerative dermal tissue. There was no purulent drainage, fat necrosis, or fluid collection identified. Copious irrigation with antibiotic solution preceded partial tissue expander deflation to facilitate skin edge reapproximation, leaving the original tissue expander and Jackson-Pratt drain (Cardinal Health, Dublin, Ohio) in place. Histology of the dermal ulcerative speci men was consistent with the clinical diagnosis of PG (Fig. 3). No bacterial growth was found in specimens.

Bottom Line: All three received systemic corticosteroid treatment, resulting in resolution of symptoms.As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction.This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, Lahey Hospital and Medical Center, Tufts University, School of Medicine, Boston, Mass.

ABSTRACT
We report 3 cases of breast pyoderma gangrenosum in patients undergoing total mastectomy with immediate reconstruction. All three received systemic corticosteroid treatment, resulting in resolution of symptoms. As experience grew, early diagnosis in the third patient helped prosthesis salvage and timely return to the original course of reconstruction. This represents the first report of prosthesis salvage from post breast reconstruction pyoderma gangrenosum, and it demonstrates that implant removal is not always necessary during management of this rare condition.

No MeSH data available.


Related in: MedlinePlus