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Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease
Gorham-Stout disease (GSD) is a rare musculoskeletal disorder characterized by progressive bone resorption and overgrowth of lymphatic vessels. The mechanism of GSD is still largely unknown. Negative-pressure wound therapy (NPWT) is known to accelerate wound healing and is used worldwide. Herein, we...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859016/ https://www.ncbi.nlm.nih.gov/pubmed/33552805 http://dx.doi.org/10.1097/GOX.0000000000003303 |
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author | Shiokawa, Ichiro Oshima, Naoya Mizumura, Nao Momosawa, Akira |
author_facet | Shiokawa, Ichiro Oshima, Naoya Mizumura, Nao Momosawa, Akira |
author_sort | Shiokawa, Ichiro |
collection | PubMed |
description | Gorham-Stout disease (GSD) is a rare musculoskeletal disorder characterized by progressive bone resorption and overgrowth of lymphatic vessels. The mechanism of GSD is still largely unknown. Negative-pressure wound therapy (NPWT) is known to accelerate wound healing and is used worldwide. Herein, we report a successful treatment of a patient with GSD having a sacral pressure ulcer, using NPWT. An 18-year-old female GSD patient was referred to our department for treating a sacral wound. The wound was disinfected by pocket incision, cleansing, and administration of antibiotics; however, the lesion remain unhealed. Histopathology of the debrided sacral wound revealed fibrous granulation tissue, with no sign of lymphatic anomalies. NPWT was started with −75 mm Hg of pressure, and neither lymphorrhea nor growth of lymphangioma was noted. Negative pressure was gradually increased to −125 mm Hg. The ulcer size decreased to 2 × 2 cm(2), which healed 3 months after hospital discharge, with no recurrence for 8 months. For progressive diseases such as GSD, NPWT may cause the regrowth of lymphangioma or other neoplasms due to an increase in vessel endothelial growth factor. NPWT appears to be one of the safest and most effective wound therapies even for this rare and difficult disease, provided the use of the following treatment protocol: Pathohistological assessment before application of NPWT, and negative pressure initially set at a low level; then, gradually increased, with careful observation to avoid lymphorrhea. When changing the foam dressing, careful checking is important to determine whether the wound is necrotic, or if there is tumor-like tissue accumulation rather than healthy granulation. |
format | Online Article Text |
id | pubmed-7859016 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-78590162021-02-05 Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease Shiokawa, Ichiro Oshima, Naoya Mizumura, Nao Momosawa, Akira Plast Reconstr Surg Glob Open Reconstructive Gorham-Stout disease (GSD) is a rare musculoskeletal disorder characterized by progressive bone resorption and overgrowth of lymphatic vessels. The mechanism of GSD is still largely unknown. Negative-pressure wound therapy (NPWT) is known to accelerate wound healing and is used worldwide. Herein, we report a successful treatment of a patient with GSD having a sacral pressure ulcer, using NPWT. An 18-year-old female GSD patient was referred to our department for treating a sacral wound. The wound was disinfected by pocket incision, cleansing, and administration of antibiotics; however, the lesion remain unhealed. Histopathology of the debrided sacral wound revealed fibrous granulation tissue, with no sign of lymphatic anomalies. NPWT was started with −75 mm Hg of pressure, and neither lymphorrhea nor growth of lymphangioma was noted. Negative pressure was gradually increased to −125 mm Hg. The ulcer size decreased to 2 × 2 cm(2), which healed 3 months after hospital discharge, with no recurrence for 8 months. For progressive diseases such as GSD, NPWT may cause the regrowth of lymphangioma or other neoplasms due to an increase in vessel endothelial growth factor. NPWT appears to be one of the safest and most effective wound therapies even for this rare and difficult disease, provided the use of the following treatment protocol: Pathohistological assessment before application of NPWT, and negative pressure initially set at a low level; then, gradually increased, with careful observation to avoid lymphorrhea. When changing the foam dressing, careful checking is important to determine whether the wound is necrotic, or if there is tumor-like tissue accumulation rather than healthy granulation. Lippincott Williams & Wilkins 2021-01-11 /pmc/articles/PMC7859016/ /pubmed/33552805 http://dx.doi.org/10.1097/GOX.0000000000003303 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Reconstructive Shiokawa, Ichiro Oshima, Naoya Mizumura, Nao Momosawa, Akira Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title | Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title_full | Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title_fullStr | Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title_full_unstemmed | Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title_short | Negative-pressure Wound Therapy for Sacral Pressure Ulcer in Gorham-Stout Disease |
title_sort | negative-pressure wound therapy for sacral pressure ulcer in gorham-stout disease |
topic | Reconstructive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859016/ https://www.ncbi.nlm.nih.gov/pubmed/33552805 http://dx.doi.org/10.1097/GOX.0000000000003303 |
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