Hyperbaric oxygen therapy in the treatment of skin ulcers due to calcific uraemic arteriolopathy: experience from an Australian hyperbaric unit.
BACKGROUND
Calcific uraemic arteriolopathy (CUA), also known as 'calciphylaxis', is a syndrome of ischaemic necrotic ulcers occurring in uraemic patients with end-stage renal failure. It is a debilitating condition with a high morbidity and mortality. Hyperbaric oxygen (HBO) has been used to treat such wounds for many years but evidence of its efficacy is limited.


OBJECTIVE
We aimed to study the efficacy of HBO on the healing of problem ulcers secondary to CUA.


METHODS
A retrospective case review of all patients with chronic skin ulcers secondary to CUA treated at the Alfred Hospital Hyperbaric Unit from July 1997 to March 2006 (n = 20).


RESULTS
HBO was beneficial in eleven (55%) patients, with six of these (30%) experiencing complete resolution of their ulcers on completion of their treatment. Advancing age was identified as a predictor of a positive outcome (P = 0.02). There was no statistical correlation between the number of HBO treatments and ulcer healing.


CONCLUSIONS
HBO can benefit patients with chronic non-healing wounds secondary to CUA, but its precise role remains undefined.
At the time of this study, a registrar in Hyperbaric Medicine at The Alfred Hospital, Melbourne, The Heart Hospital Westmoreland Street, London W1G 8PH, England, Phone: +44-(0)20750-43160, Fax: +44-(0)20750-48847, E-mail: markedsell@doctors.org.uk.
Mark
M
Edsell
Michael
M
Bailey
Keith
K
Joe
Ian
I
Millar