We currently have two research interests as outlined below. These activities are being carried out in conjunction with our inpatient wound care program at Promise Hospital in The Villages Florida.
- Calciphylaxis (ICD 10 E83.59): Calciphylaxis (CPX) is a potentially fatal disorder of calcium metabolism. The hallmark of this disorder is painful, disfiguring, necrotic wounds. It occurs in disorders of calcium metabolism characterized by hypercalcemia (high calcium). The most common condition, by far, is renal failure on dialysis. According to research at Sao Paulo State University, CPX occurs in 1-5% of all dialysis patients and traditionally carried a 60-80% mortality. According to a study published in The American Journal of Kidney Diseases, people with CPX have a one-year survival rate less than 46%. Death is usually the result of complications like infection and sepsis. The painful wounds are caused by calcium deposition and obstruction of the tiny arteries in fat and subcutaneous tissue. Once blocked, the tissue supplied by these vessels dies, causing the wounds that lead to disability and death.
Traditionally, there has been no cure for this illness and treatment has existed of palliative treatment of the wounds, attempting to minimize infection. These wounds can’t be treated in the traditional way as debridement only makes them worse. In 2015 we stumbled onto a medication previously not reported as a main medication for this condition. We found it to be dramatically effective, reversing wound size and even curing the disease in certain cases. Our current study seeks to document the treatment of a group of patients with this illness using this medication. Once we have 10-15 patients we will publish our results. Clinicians please consider referring us any patients suspected of having this condition.
- Regenerative Healing. We are currently working with a medical device manufacturer to fund a study looking at the use of skin substitute products in pressure ulcers. Currently, these products are only indicated and approved for specific leg wounds. We have used them successfully for pressure ulcers for some time in the hospital setting. Demonstrating this in a scientific study can lead to approval and reimbursement opening up the use of these products for a wider group of patients. We also will demonstrate the way these products work by proving the regenerative nature of these products. We can accomplish this by doing a biopsy of the wound as it heals. Wounds healing regeneratively will have muscle filling in the wound. Wounds that heal the traditional way will have scar in the wound. With regenerative healing the wound repairs itself by producing the native tissue, not scar. This is accomplished by using the patient’s own stem cells (see our essay on regenerative medicine). Finally, we hope to do a head to head study comparing two products in this class for healing ability and regenerative capacity.