TY  - BOOK
AU  - Akbari, Cameron M
AU  - Margulies, Ilana
AU  - Steinberg, John
TI  - Surgical management of pain or infection secondary to calciphylaxis: a wound center's experience and algorithmic multidisciplinary approach
SN  - 1044-7946
PY  - 2023///
KW  - *Calciphylaxis
KW  - Adult
KW  - Aged
KW  - Amputation, Surgical
KW  - Calciphylaxis/et [Etiology]
KW  - Calciphylaxis/su [Surgery]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Pain
KW  - Quality of Life
KW  - Retrospective Studies
KW  - Surgical Wound Infection/th [Therapy]
KW  - Wound Healing
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Plastic Surgery Residency
KW  - Surgery/Podiatric Surgery
KW  - Case Reports
KW  - Journal Article
N2  - BACKGROUND: The role of surgical management of calciphylaxis remains understudied; CONCLUSION: While the morbidity and mortality associated with calciphylaxis are substantial, surgical excision is effective in reducing pain and improving quality of life in patients with this end-stage disease. Wound care centers are uniquely equipped with a variety of medical and surgical specialists with experience in treating chronic wounds and thus facilitate an efficient multidisciplinary model; METHODS: A single-center retrospective review of all adult patients with calciphylaxis treated surgically between January 2010 and November 2022 was performed; OBJECTIVE: This article reports a case series and algorithmic approach to the multidisciplinary management of calciphylaxis; RESULTS: Eleven patients met inclusion criteria. The average age was 50.9 years +/- 15.8 SD, and most patients were female (n = 7 [63.6%]). Surgery was indicated for infection (n = 6 [54.5%]) and/or intractable pain (n = 11 [100%]). Patients underwent an average of 2.9 excisional debridements during their hospital course. Following the final excision, wounds were left open in 5 cases (29.4%), closed primarily in 4 (23.5%), and local flaps were used in 3 (27.3%). Postoperatively, the mean time to healing was 57.4 days +/- 12.6. Complications included dehiscence (n = 1 [9.1%]), progression to cellulitis (n = 2 [18.2%]), osteomyelitis (n = 1 [9.1%]), and lower extremity amputation (n = 2 [18.2%]). Of the 6 patients alive at the time of healing, 5 (83.3%) were no longer taking narcotic medications. At an average follow-up of 26.4 months +/- 34.1, 7 patients (63.6%) were deceased, with an average time to mortality of 4.8 months +/- 6.7. Of the 4 remaining patients, 3 (75.0%) were ambulatory by their most recent follow-up visit
UR  - https://dx.doi.org/10.25270/wnds/23048
ER  -