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In general, we attempt to protect patients with pyoderma gangrenosum from the knife, as debridement and grafting usually fail and may result in spread of the lesion. This report1 of 29 patients admitted to the hospital for treatment details one center's experience with surgical treatments “under immunosuppressive cover.” Most of the patients (8 of 10) who underwent combined therapy had complete healing. The authors report four deaths, all due to septicemia — two following surgery (1 abdominal surgery for ulcerative colitis, 1 following below-knee amputation). All of the deaths occurred in patients in their 70s and 80s.
Bottom line: In carefully selected patients, a combination of medical and surgic…