title: Successful Surgical Treatment of Severe Calciphylaxis Using a Bilayer Dermal Replacement Matrix.
abstract: Cutaneous calciphylaxis is a rare and often intractable disease that involves subcutaneous vascular calcification, ischemia, and subsequent necrosis. Calciphylaxis has an associated 60%-80% mortality rate with sepsis as the leading cause of death. However, despite variable success rates, the proper treatment of calciphylaxis remains controversial. In this case report, the authors present a 42-year-old female who presented with bilateral lower extremity calciphylaxis in conjunction with long-standing liver disease and acute renal failure. Cure of the patient's calciphylaxis was achieved through a surgical approach using staged debridement, placement of a dermal regenerative template (Integra Dermal Regeneration Template, Integra Lifesciences, Plainsboro, NJ), and followed by successful skin grafting. This is the first successful treatment of calciphylaxis in the literature to date using dermal regenerative template material.
authors.affiliation: Mayo Medical School,Rochester, Minnesota.
authors.forename: Dipesh
authors.initials: D
authors.lastname: Solanky
authors.affiliation: Mayo Medical School, Rochester, Minnesota.
authors.forename: Soyun M
authors.initials: SM
authors.lastname: Hwang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California.
authors.forename: Gregory
authors.initials: G
authors.lastname: Stone
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California.
authors.forename: Justin
authors.initials: J
authors.lastname: Gillenwater
authors.affiliation: Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, California.
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Carey
mesh_terms: D000328:Adult; D002115:Calciphylaxis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003646:Debridement / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000503:physiopathology*; D008111:Liver Function Tests; D009336:Necrosis / Q000473:pathology / Q000601:surgery*; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply* / Q000473:pathology; D016038:Skin Transplantation / Q000379:methods*; D013848:Thigh / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing