Hyperbaric oxygen therapy in the treatment of skin ulcers due to calcific uraemic arteriolopathy: experience from an Australian hyperbaric unit.

INTRODUCTION

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.

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

METHOD: 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.