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Post-Surgical Pyoderma Gangrenosum Following Foot and Ankle Surgery: A Systematic Review
Biao Zhang1, Kayla Obradovic1, Rochelle Greenberg1
1New York College of Podiatric Medicine, Touro University, New York, NY 10035, USA.
Journal of the American Podiatric Medical Association
|July 24, 2026
Summary
Post-surgical pyoderma gangrenosum (PSPG) is often misdiagnosed. Early recognition and immunosuppressant treatment are vital for healing worsening wounds and preventing severe outcomes like amputation.
Area of Science:
- Dermatology
- Surgical Pathology
- Wound Healing
Background:
- Post-surgical pyoderma gangrenosum (PSPG) presents diagnostic challenges, frequently mistaken for infections.
- This confusion leads to delayed or incorrect patient management, increasing morbidity.
Purpose of the Study:
- To review characteristics, management, and outcomes of PSPG after foot and ankle surgery.
- To enhance diagnostic accuracy and improve patient care for PSPG.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Embase up to January 2023.
- Analysis of ten PSPG cases following foot and ankle surgery, focusing on demographics, presentation, treatment, and outcomes.
Main Results:
- Predominantly affected females with rapidly progressing, painful postoperative ulcers.
- High rate of negative cultures; dermatology consultation suspected 83.33% of cases.
- 30% of female patients diagnosed late (>35 days) underwent amputation; immunosuppressants, especially corticosteroids, were effective.
Conclusions:
- Suspect PSPG in unexplained, worsening postoperative wounds.
- Early diagnosis and immunosuppressant therapy are crucial to prevent severe outcomes.
- Multidisciplinary care involving dermatology and surgery is recommended.
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