[Sterile maggots as adjuvant procedure for local treatment in a patient with proximal calciphylaxis]

Proximal calciphylaxis with skin ulcerations has a very poor survival and infection is the main cause of the high mortality rate. We present the case of a diabetic obese hemodialysis woman diagnosed of severe calciphylaxis with extensive ulcers in the abdomen and left thigh. After a first ineffective debridement attempt, systemic medical treatment was associated with daily wet cures with enzymatic ointments and maggot therapy resulting in spectacular granulation and healing of these ulcers. We want to underline the great properties of sterile maggots to selectively dissolve necrotic tissue, to disinfect the wound and to stimulate healing. Thus, sterile-maggot debridement may constitute a very good adjuvant treatment even in proximal ulcers of calciphylaxis, preventing systemic infection.