Key result
Maggot debridement therapy and LMWH switch successfully resolve severe warfarin-induced skin necrosis.
Case Report (n=1)
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A patient with a history of deep vein thrombosis presented with painful bruising and blistering on his left leg 7-10 days after warfarin treatment. A complicated 2-month treatment followed, where vasculitis was originally diagnosed from histological findings before the final diagnosis of warfarin-induced skin necrosis (WISN) was made on clinical grounds. Warfarin was stopped, reversed and low molecular weight heparin started but, the lesions had progressed to full thickness necrosis. This was originally treated with conventional surgical debridement before introducing maggot debridement therapy (MDT) in an effort to try to salvage the limb.
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Biscoe et al. (2013) conducted a case report in Warfarin-induced skin necrosis (n=1). Maggot debridement therapy, warfarin cessation/reversal, low molecular weight heparin, and conventional surgical debridement was evaluated on Limb salvage and resolution of full-thickness skin necrosis. Maggot debridement therapy and warfarin switching to LMWH were used over 2 months to treat full-thickness warfarin-induced skin necrosis arising 7-10 days after warfarin initiation in 1 patient.
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