In January, I asked for your help with a survey about amputations due to pyoderma gangrenosum (PG). Thanks to all of those who responded, and my apologies that I am asking you to do it again. Let’s just say that there were technical difficulties with the survey (not my fault!)… Here’s the new link to complete it.
There’s a reason we are asking about this. Dr. Alex Ortega has been a godsend to many wound care practitioners left to care for complicated PG patients without help from dermatology or rheumatology. In my 30-plus years of practicing wound care, I have developed an unwelcome amount of experience with Pyoderma gangrenosum. It’s not been uncommon for me to have 8 patients with PG at any given time (and I’m sure I’ve missed some). The problem comes when you try to get a real expert to help you. You find out that you have seen more cases than they have.
PG can range in spectrum from a smoldering but refractory small lesion to a limb threatening debacle. Some patients with PG died of their associated comorbid diseases. In one of my patients, amputation was the best option- but amputation would have been an option for others – if they had lived. This photo is of a patient whose PG was a paraneoplastic syndrome from the sarcoma that took his life.
Many dermatologists have told me they’ve never seen a single case of PG. Wound care practitioners may have more experience with PG than the average dermatologist, and that’s why dermatologist Dr. Alex Ortega-Loyoza has asked for our help.
Dr. Ortega has been researching PG for many years. He recently performed a review of the literature which suggested that PG may lead to amputation far more often than commonly thought. However, his dermatology colleagues were skeptical that this is the case.
The fact is, wound care doctors are a better source of information on this subject than dermatologists. He wrote a guest editorial in my column for Today’s Wound Clinic.
Read Dr. Ortega’s brief editorial on the subject of PG and amputation, and take the quick survey!
If anyone would know the truth about PG and amputation – it’s us.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
Hello Dr, Fife.
In the photo, I look at where the skin is not affected and I find that it is covered: either with fat, or with sclerosis, or both. If this is the case for the whole body, there is no possibility of obtaining closure of the wound. Cutaneous clearance becomes crucial, both for hot flashes and for liquid vapor excretion. I suggest you consider Dr. Soo-Kyoung Choi’s study
By intensively cleansing both arms and legs and the soles of the feet, with an emulsifying product that will break down the hydrophobic barrier of keratinocytes to facilitate the recycling of crusts and cellular debris. the whole body will be refreshed and the pores will be cleared. I am convinced that there, a result will be possible to counter the aggravation of the injury.
This treatment provides two solutions, no less negligible. 1) it helps restore local pressure and temperature, supported by the restorative metabolic system. 2) cleaning the skin restores good communication between the thousands of skin sensors, with the organs that depend on them to decide on the reactions or counter-reactions to develop. And, the medical treatments that come in support are, automatically, more effective. This is the ready-made conclusion of my 35 years of research on chronic injury issues.