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Clinical efficacy of human split-thickness skin allograft in patients with pyoderma gangrenosum: a case series.

INTRODUCTION
Pyoderma gangrenosum (PG) is an uncommon inflammatory skin disease that is characterized clinically by the development of painful pustules that subsequently progress to large cutaneous ulcers. There is no universally effective treatment for PG, and a combination of local and systemic therapies is often used to manage it. Biologically active, cryopreserved human skin allograft (BSA) has become a standard part of the treatment algorithm for complex nonhealing wounds. These allografts facilitate the wound healing cascade by delivering the essential biologically active compounds of fresh skin to the wound bed and promoting wound bed revascularization.


OBJECTIVE
The purpose of this case series was to illustrate how the use of human split-thickness allografts positively contributes to wound healing in patients with PG.


CASE PRESENTATIONS
Five cases highlighting the efficacy of a BSA in achieving clinical wound healing in patients with complex PG ulcerations are presented. Clinical findings appear to indicate that the positive effect of BSA in combination with systemic therapies on wound beds in patients with PG is because of a combination of both the unique alterations in the patient's immune system in addition to the possible delays in clearance of cellular components of the allograft, which promote the strong inosculation and revascularization necessary for wound healing.


CONCLUSIONS
The BSA studied herein appears to aid in wound healing because it has natural components found in human skin that facilitate wound healing, and it eliminates the potential for pathergy because no graft harvesting from the host is performed. These allografts can be applied numerous times, and each has the major essential components of human skin wound healing for a more rapid and complete epithelialization.