(CS-099) A Favorable Response to Hyperbaric Oxygen Therapy and Mirragen in Pyoderma Gangrenosum: A Case Report

Kristen Alario, RN, BSN, CWON; Andrew Agos, MD, FACS; Dana Anderson, MD, surgical resident UCM; Peter Chioros, MD, FACFAS; Jordan Hawkins, B.S., M.B.S., DPM; Mehreen Rahim, DPM, M.S, MPH; Melanie Vaisberg, B.S., DPM

Introduction: We present a case of a 56-year-old diabetic male with an 18 month old non-healing ulcer of the left lower leg that was initially misdiagnosed and worsened despite antibiotics, debridement, and standard wound care. Eventually, a diagnosis of pyoderma gangrenosum was considered by exclusion.

Methods: Patient was treated with 40 sessions of hyperbaric oxygen therapy and 16 applications of a borate based bioactive glass wound matrix (Mirragen) in addition to the standard of care for PG cases which includes oral and topical steroid therapy.

Results: This therapy regimen has resulted in a 99% reduction in surface area from the wound's largest size at 117 sq cm; prior to the PG diagnosis. This also resulted in a 98% reduction in size since the initiation of the therapies mentioned above.

Discussion: This case suggests that combining HBOT with advanced wound matrices like Mirragen may offer a novel and effective therapeutic option for managing complex cases of pyoderma gangrenosum, especially in patients with co-morbidities such as diabetes.