Perforator propeller flap for coverage of Achilles region defects caused by pyoderma gangrenosum
Chun Wa Fong,
Manuel Bento,
Feng Jun Fang,
Fong Kuong Pang,
Io Hang Lio,
Sut Sin Tong,
Chou Kuan Hao
Affiliations
Chun Wa Fong
Corresponding author.; Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Manuel Bento
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Feng Jun Fang
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Fong Kuong Pang
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Io Hang Lio
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Sut Sin Tong
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
Chou Kuan Hao
Department of Plastic and Reconstructive Surgery, Centro Hospitalar Conde São Januário, Estrada do Visconde de S. Januário, Macau SAR
ABSTRACT: Pyoderma gangrenosum (PG) is a rare neutrophilic inflammatory skin disease. Systemic corticosteroid and immunosuppressive agents are the mainstay treatment. PG usually precludes a surgical approach due to pathergy phenomenon. Recent literatures show skin grafting and negative pressure wound therapy are safe if performed under adequate immunosuppression. We present a case of a 61-year-old male patient suffered from PG induced left posterior leg wound with Achilles tendon exposure. We made timely diagnosis and treated him with adequate immunosuppression therapy followed by perforator propeller flap for wound coverage. This case report emphasizes the need for high index of suspicion for PG diagnosis. Furthermore, with adequate immunosuppression, operative intervention may not be an absolute contraindication for PG.
