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Deep Ulcer Shaving Combined With Split-Skin Transplantation in Distal Calciphylaxis

Department of Dermatology and Allergology, Academic Teaching Hospital of the University of Dresden, wollinauw{at}khdf.de

Catherine Helm, MD

Department of Dermatology and Allergology, Academic Teaching Hospital of the University of Dresden

Gesina Hansel, MD

Department of Dermatology and Allergology, Academic Teaching Hospital of the University of Dresden

André Koch, MD

Department of Dermatology and Allergology, Academic Teaching Hospital of the University of Dresden

Jaqueline Schönlebe, MD

Institute of Pathology Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the University of Dresden, Dresden, Germany

Gunter Haroske, MD

Institute of Pathology Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the University of Dresden, Dresden, Germany

Erich Köstler, MD

Department of Dermatology and Allergology, Academic Teaching Hospital of the University of Dresden

Calciphylaxis is a cause of painful deep ulcers. There is controversy about best wound management in this disease. A retrospective study of inpatients during the 3 years was made. Seven calciphylaxis patients were identified. All patients suffered from various associated pathologies including diabetes mellitus type II and chronic renal insufficiency. Ulcers were treated by aggressive and deep shaving combined with autologous split-skin grafting in the same session. A 30% to 90% take rate of the grafts eventually with a complete ulcer healing in 6 of 7 patients was achieved. No patient developed a deep cutaneous infection or sepsis. All patients are still alive except one. The single death was related to cardiovascular complications. In distal calciphylaxis, aggressive ulcer surgery with defect closure offers a marked improvement in quality of life and prevents early deep skin infections and sepsis as major causes of mortality.

Key Words: calciphylaxis • ulcer surgery • split-skin grafting • sepsis • pain

The International Journal of Lower Extremity Wounds, Vol. 7, No. 2, 102-107 (2008)
DOI: 10.1177/1534734608317891


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