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Postoperative Pyoderma Gangrenosum After Thoracolumbar Spinal Fusion with Instrumentation: A Case Report
J Taylor Bellamy1, Dheera Ananthakrishnan
1Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia.
Case:
A 65-year-old man with scoliosis underwent posterior spinal fusion with instrumentation from T4 to pelvis and subsequently developed wound complications eventually diagnosed to be secondary to postoperative pyoderma gangrenosum (PPG). Once immunosuppressant medications were initiated, the wound gradually improved and went on to heal after a prolonged period of wound care.
Conclusion:
Postoperative PG is a challenging problem for the orthopaedic surgeon; a multidisciplinary approach is beneficial. Early recognition of the diagnosis is imperative to limit morbidity because debridements for a presumed infectious etiology are likely to exacerbate the disease through a process called pathergy.
