PDF(Pubmed)
Abstract：
Vasculitic and pyoderma gangrenosum ulcers are traditionally treated with immunosuppressants, and the role of surgery in the treatment of these atypical ulcers remains unclear. This study aimed to investigate the need for surgical intervention as well as the outcome and safety of skin grafting in the treatment of 46 patients with vasculitic ulcers and 34 with pyoderma gangrenosum ulcers using data recorded in the validated Wound Registry. Of the 80 patients with atypical ulcers, 14% (n = 11) were treated surgically; these patients were older (p = 0.039), had lower mobility status (p = 0.002), and more often pulmonary diseases, rheumatoid arthritis, and previous arterial procedures (p = 0.007; p = 0.031; p = 0.031, respectively) than those treated conservatively. Of 181 ulcers, 15% (n = 27) were surgically treated, 78% once and 22% multiple times. During follow-up, 92.3% of both surgically and conservatively treated ulcers with available data healed. Of the surgically treated ulcers, median healing time after first surgical procedure was 96 days, and post-surgical complications were considered mild or unrelated to surgery. Our results suggest that if surgery is indicated, skin grafting is a safe and efficient treatment method provided that multidisciplinary approach is applied.
摘要：
血管和脓皮病坏疽性溃疡传统上是用免疫抑制剂治疗的，手术在这些不典型溃疡治疗中的作用尚不清楚.本研究旨在使用经过验证的WoundRegistry中记录的数据，调查46例血管溃疡和34例坏疽性脓皮病患者的手术干预需求以及皮肤移植的结果和安全性。80例非典型溃疡患者中,14％（n=11）接受手术治疗；这些患者年龄较大（p=0.039），具有较低的移动性状态(p=0.002)，更常见的是肺部疾病，类风湿性关节炎,和以前的动脉程序（p=0.007;p=0.031;p=0.031，分别）比保守治疗。在181个溃疡中,15%(n=27)接受手术治疗，78%一次和22%多次。随访期间,92.3％的手术和保守治疗的溃疡与现有数据治愈。在手术治疗的溃疡中，首次手术后的中位愈合时间为96天，术后并发症被认为是轻度的或与手术无关.我们的结果表明，如果需要手术，如果采用多学科方法，皮肤移植是一种安全有效的治疗方法。
