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Pyoderma Gangrenosum

Pyoderma Gangrenosum (PG) has become known as the great marauder  because it is often mistaken for more common ulcerative wounds, such as arterial insufficiency wounds or necrotizing wounds, both of which are Undersea and Hyperbaric Medical Society (UHMS) approved indications for hyperbaric oxygen therapy (HBOT.) Although there have been case reports of successful treatment of PG wounds with HBOT since 1974, there have not been any large randomized and controlled research studies to support this observed effect and therefore, the treatment is not recommended for reimbursement by the UHMS. The condition is believed to be caused by an autoimmune attack, that once ulcerates, is susceptible to infection. The condition is rare, affecting 1 in 100,000 people, mostly in their middle years.

The research studies below discuss cases of varying severity, using a variety of treatments in combination with HBOT. The most serious of them include skin grafting, which is also a UHMS approved condition for HBOT. The typical treatment protocol used in these studies is the same that is used when treating other wounds or ulcerations of the skin. A pressure of 2.5 ATA (50 fsw) is used for 90-minutes, once a day until wound closure. Some wounds were closed with as little as 15 treatments, while others including skin grafting over large sections of the body, required over 80 treatments.

Scientific Resources

  • 2015 - Inpatient management of pyoderma gangrenosum: treatments, outcomes, and clinical implications.
  • 2014 - Evaluation of hyperbaric oxygen therapy for chronic wounds.
  • 2014 - Chronic leg ulcers in adult patients with rheumatological diseases - a 7-year retrospective review.
  • 2014 - A favourable response to surgical intervention and hyperbaric oxygen therapy in pyoderma gangrenosum.
  • 2013 - Pyoderma gangrenosum: A case report of bilateral dorsal hand lesions and literature review of management
  • 2013 - Pyoderma gangrenosum: skin grafting and hyperbaric oxygen as adjuvants in the treatment of a deep and extensive ulcer.
  • 2013 - Refractory postsurgical pyoderma gangrenosum in a patient with Beckwith Wiedemann syndrome: response to multimodal therapy.
  • 2013 - Autoinflammatory skin disorders in inflammatory bowel diseases, pyoderma gangrenosum and Sweet's syndrome: a comprehensive review and disease classification criteria.
  • 2011 - Hyperbaric oxygen therapy as an adjuvant treatment for pyoderma gangrenosum.
  • 2011 - Pyoderma gangrenosum: a report of a rare complication after knee arthroplasty requiring muscle flap cover supplemented by negative pressure therapy and hyperbaric oxygen.
  • 2011 - Improvement of ulcerative pyoderma gangrenosum with hyperbaric oxygen therapy.
  • 2009 - Neutrophilic dermatoses: a review of current treatment options.
  • 2009 - [Hyperbaric oxygen therapy as an adjuvant treatment for pyoderma gangrenosum]. (Spanish)
  • 2007- Pyoderma gangrenosum: dermatologic application of hyperbaric oxygen therapy.
  • 2006 - Managing pyoderma gangrenosum: a synergistic approach combining surgical débridement, vacuum-assisted closure, and hyperbaric oxygen therapy.
  • 2002 - Pyoderma gangrenosum: a great marauder.
  • 2000 - Therapy: Hyperbaric Oxygen as the Only Effective Treatment in Mutilating and Resistant Systemic Vasculitis.
  • 1993 - Pyoderma gangrenosum of the orbit.
  • 1992 - Pyoderma gangrenosum treated with hyperbaric oxygen therapy.
  • 1988 - Pyoderma gangrenosum and progressive cutaneous ulceration.
  • 1987 - Pyoderma gangrenosum: skin grafting after preparation with hyperbaric oxygen.
  • 1984 - Hyperbaric oxygen therapy for pyoderma gangrenosum. (no abstract)
  • 1978 - Hyperbaric oxygen treatment of pyoderma gangrenosum.(no abstract)
  • 1974 - Hyperbaric oxygen therapy for pyoderma gangrenosum. (no abstract)
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