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524year6, 7). PG is diagnosed by excluding other similar entities caused by infection, vasculopathies, neoplasms, and various inflammatory conditions8). Inflamma-tory bowel disease, rheumatologic disorders, and hematologic malignancies are comorbid conditions frequently associated PG9). Untreated PG is poten-tially life-threatening, and patients with PG have a three-fold increased risk of death compared to the general population; therefore, immediate and appro-priate treatment is essential10-12). Aside from mortality, PG may cause pain and adversely impact the quality of life, predispose to secondary infection, disfiguring scarring, and recur5, 7). PPG is also classified as postsurgical or pathergic and is closely associated with superficial granulo-matous pyoderma3). Systemic disease is reported to occur in 50%-78% of patients with PG, whereas a low prevalence of the systemic disease has been reported in PPG6, 10, 13-15). Suggesting that the coex-istence of systemic diseases that are typical of PG may not be important in suspecting PPG. No comor-bidity of systemic diseases related to PG was observed in this case. PPG commonly occurs in the breast, abdomen, and lower legs, in that order, at an average age of 50 years, and often occurs about 1 week postoperatively15).The common theme of all PPG literature is that the condition is almost always misdiagnosed as an SSI15-18). Stanislav et al. reported that 73% of patients with PPG were initially misdiagnosed as SSI and eventually treated15). Because fever, wound pain, and increased inflammatory response in blood tests and wound changes are also characteristic clinical findings of SSI; thus, the rarity of PPG can result in a false diagnosis. Currently, laparoscopic and robotic surgery have been introduced and widely performed in gastrectomy for gastric cancer due to their low invasiveness and cosmetic outcomes. The occurrence of SSIs is associated with an excess postoperative hospital stay, decreased quality of life, increased treatment costs, and increased mortality19). Although the standard of care for SSI is indisputably antibacterial therapy and appro-priate debridement, a paradoxical relationship between SSI and PPG treatment must be consid-ered. Our case was also regarded as SSI and treated with antibiotics, open drainage, Penrose drain® placed, and wound lavage; however, the wound condition wound severely deteriorated. One of the important points is that drainage, considered to be effective for wound infections, can worsen the wound condition in PPG15, 20, 21). Furthermore, no bacteria were detected in the wound culture test in PPG, and histological examination only shows nonspecific inflammatory findings, which will be useful in ruling out SSI. In the present case, only three of the five port wounds developed PG. The reason for this seems that all three port wounds were 12-mm ports, which are frequently manipu-lated intraoperatively, and the laparoscopy and forceps manipulations can easily cause strong physical irritation to the wounds, which is possibly contributed to the development of PG.The treatment for PPG is generally the same as PG; corticosteroid and cyclosporine therapies are supported best by the literature11, 22). Zuo et al. reported that the majority of patients were treated with oral prednisolone (0.5-1.5 mg/kg/day) or intravenous methylprednisolone (0.5-1.0 mg/kg/day) combined with/without cyclosporine18). If the patient is resistant to these treatments, other treat-ments such as mycophenolate mofetil, infliximab, tacrolimus, or plasmapheresis may be consid-ered5, 21). Moreover, steroid and immunosuppres-sive therapies for the treatment of PPG are predis-posed to wound infections and can exacerbate existing infections; therefore, they should be used cautiously5, 21, 23). As for the treatment of the wound itself, as mentioned earlier, drainage should not be performed as it will worsen the condition. Main-taining a moist environment after washing with saline is important to promote proper wound healing24). Consistent with this case, systemic symp-toms, laboratory findings, and wound condition dramatically improved with 50 mg (1 mg/kg/day) of oral prednisolone and wound care that avoided external stimuli as much as possible.Although PPG is a rare disease, general surgeons should consider PPG as one of the differential diag-noses and treatments when managing an untypical course of SSI. Postoperative wound abnormalities that are resistant to the standard treatment should be referred to a dermatologist at an early stage of treatment, if possible, as the addition of expert judgment can lead to earlier diagnosis and treatment.We managed a rare case of PPG that occurred in Conclusion