Severe postoperative wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency: the impact of augmentation therapy

Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (A...

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Bibliographic Details
Published in:International wound journal 2015-10, Vol.12 (5), p.601-604
Main Authors: Cathomas, Marionna, Schüller, Alexandra, Candinas, Daniel, Inglin, Roman
Format: Article
Language:English
Subjects:
alpha 1-Antitrypsin - therapeutic use
alpha 1-Antitrypsin Deficiency - complications
alpha 1-Antitrypsin Deficiency - diagnosis
alpha 1-Antitrypsin Deficiency - drug therapy
Alpha‐1‐antitrypsin deficiency
Case Report
Case Reports
Humans
Laparotomy
Laparotomy - adverse effects
Male
Middle Aged
Panniculitis
Panniculitis - diagnosis
Panniculitis - etiology
Panniculitis - therapy
Postoperative
Surgery
Surgical Wound Dehiscence - etiology
Surgical Wound Dehiscence - therapy
Trypsin Inhibitors - therapeutic use
Wound Healing - physiology
Wound healing disturbance
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Summary:Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work‐up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease‐related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.
ISSN:1742-4801
1742-481X
DOI:10.1111/iwj.12419