What is the role of surgery in the treatment of calciphylaxis?

Updated: Feb 24, 2020
  • Author: Julia R Nunley, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Aggressive wound care and debridement of necrotic tissue may be necessary to avoid wound infection and sepsis. [6] However, some advise against debridement. Currently, there is no consensus on wound management. [17] The decision to debride, and to what extent, depends on the patient's overall health and the clinical picture.

Use of a vacuum-assisted closure device has been successful in several cases of calciphylaxis after extensive debridement and prior to skin grafting. [83]

Total or subtotal parathyroidectomy with autotransplantation may be of therapeutic benefit. [6, 49, 84, 85, 86]  Small case studies have demonstrated some benefit; however, other larger retrospective studies have shown no significant difference in survival. [17] Decisions should be made on a case-to-case basis.


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