CASE STUDY

Treatment of Pyoderma Gangrenosum

Jackie ClemitSalts Community Stoma Care Nurse

CASE STUDY

Patient •Female-80 yrs

•Stoma formed 3 years ago for inflammatory bowel disease.

•Surgery performed in Scotland

•2008 diagnosed and treated for Pyoderma.

CASE STUDY

Diagnosis and treatment•Request for a community visit due to painful stoma

•Visited same day

•Pyoderma Gangrenosum identified

•Haelan tape suggested as first treatment.

CASE STUDY

Treatment continued•Haelan tape applied to ulcerated area.

•Large Secuplast mouldable seal applied to full surface area, adhered to wet skin

•Pouch applied

•Secuplast flange extensions applied to outer area.

CASE STUDY

Treatment Continued•District nurse contacted to continue dressings x 2 weekly.

•One week later there was only a slight improvement

•GP contacted

•Tacrolimus 0.3% in orabase paste, prescribed

CASE STUDY

Treatment Continued•Revisited the following week ointment applied

•Care plan given to district nurse

•Follow up visit one week later

•After 1 week of treatment

CASE STUDY

•District nurse redressed every other day.

•Ulceration was healed one week later

CASE STUDY

Results•Continued use of Secuplast mouldable due to comfort

•Ointment kept as a standby

•Ulcer completely healed

CASE STUDY

Fully Healed in 3 weeks

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