Table 1.

Item selection from the original Bates-Jensen Wound Assessment Tool (BWAT) to develop a modified version for calcific uremic arteriolopathy (BWAT-CUA).

BWAT Item	Scores	Included/Excluded in BWAT-CUA: Rationale
Necrotic tissue type	1 = None visible; 2 = White/grey non-viable tissue and/or non-adherent yellow slough; 3 = Loosely adherent yellow slough; 4 = Adherent soft black eschar; 5 = Firmly adherent hard black eschar	Included Calciphylaxis is often diagnosed late, when necrosis is already present. Reduction of necrotic tissue may be a sensitive indicator of improvement.
Necrotic tissue amount	1 = None visible; 2 = <25% of wound bed covered; 3 = 25% to 50% of wound covered; 4 = >50% but <75% of wound covered; 5 = 75% to 100% of wound covered	Included See necrotic tissue type.
Exudate type	1 = None; 2 = Bloody; 3 = Serosanguineous: thin, watery, pale red/pink; 4 = Serous: thin, watery, clear; 5 = Purulent: thin or thick, opaque, tan/yellow, with or without odor	Included Particularly pertinent in calciphylaxis wounds, which have a high risk of infection; ~50% of patients with calciphylaxis have sepsis as an attributable cause of death.
Exudate amount	1 = None, dry wound; 2 = Scant, wound moist but no observable exudate; 3 = Small; 4 = Moderate; 5 = Large	Included See exudate type.
Skin color surrounding wound	1 = Pink or normal for ethnic group; 2 = Bright red and/or blanches to touch; 3 = White or grey pallor or hypopigmented; 4 = Dark red or purple and/or non-blanchable; 5 = Black or hyperpigmented	Included Erythema is often seen in calciphylaxis wounds; it can assist with the diagnostic process as well as with monitoring wound progression and infection.
Peripheral tissue edema	1 = No swelling or edema; 2 = Non-pitting edema extends <4 cm around wound; 3 = Non-pitting edema extends >4 cm around wound; 4 = Pitting edema extends <4 cm around wound; 5 = Crepitus and/or pitting edema extends >4 cm around wound	Included Edema is often seen in calciphylaxis wounds; it can assist with the diagnostic process as well as with monitoring wound progression and infection.
Peripheral tissue induration	1 = None present; 2 = Induration <2 cm in any area around wound; 3 = Induration 2–4 cm extending <50% around wound; 4 = Induration 2–4 cm extending >50% around wound; 5 = Induration >4 cm in any area around wound	Included Induration is often seen in calciphylaxis wounds; it can assist with the diagnostic process as well as with monitoring wound progression and infection.
Granulation tissue	1 = Skin intact or partial thickness wound; 2 = Bright, beefy red; 75% to 100% of wound filled and/or tissue overgrowth; 3 = Bright, beefy red; >25% to <75% of wound filled; 4 = Pink, and/or dull, dusky red and/or fills <25% of wound; 5 = No granulation tissue present	Included As calciphylaxis wounds improve it is expected that there will be increased granulation tissue. Granulation tissue indicates commencement of healing, particularly for slow-healing calciphylaxis wounds.
Excluded Items
Undermining	0 = Healed, resolved wound; 1 = None; 2 = Undermining <2 cm in any area; 3 = Undermining 2–4 cm involving <50% wound margins; 4 = Undermining 2–4 cm involving >50% wound margins; 5 = Undermining >4 cm or tunneling in any area	Excluded Undermining is not a characteristic feature of calciphylaxis wounds.
Size	0 = Healed, resolved wound; 1 = Length × width <4 cm2; 2 = Length × width 4 to <16 cm2; 3 = Length × width 16.1 to <36 cm2; 4 = Length × width 36.1 to <80 cm2; 5 = Length × width >80 cm2	Excluded Ranges are broad and wound size is not a sensitive measure for slow-healing wounds like calciphylaxis.
Depth	0 = Healed, resolved wound; 1 = Non-blanchable erythema on intact skin; 2 = Partial thickness skin loss involving epidermis and/or dermis; 3 = Full thickness skin loss involving damage or necrosis of subcutaneous tissue; may extend down to but not through underlying fascia; and/or mixed partial & full thickness and/or tissue layers obscured by granulation tissue; 4 = Obscured by necrosis; 5 = Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures	Excluded The depth descriptions for BWAT correspond to pressure ulcer stages. Calciphylaxis lesions usually present as either necrotic or full-thickness lesions; thus, this item was most likely to be binary (4 or 5) and redundant with the BWAT item for necrotic tissue type.
Edges	0 = Healed, resolved wound; 1 = Indistinct, diffuse, none clearly visible; 2 = Distinct, outline clearly visible, attached, even with wound base; 3 = Well-defined, not attached to wound base; 4 = Well-defined, not attached to base, rolled under, thickened; 5 = Well-defined, fibrotic, scarred or hyperkeratotic	Excluded Edges are less relevant in slow-healing calciphylaxis wounds, which tend to heal from the base up.
Epithelialization	1 = 100% wound covered, surface intact; 2 = 75% to <100% wound covered and/or epithelial tissue extends >0.5 cm into wound bed; 3 = 50% to <75% wound covered and/or epithelial tissue extends to <0.5 cm into wound bed; 4 = 25% to <50% wound covered; 5 = <25% wound covered	Excluded Late feature of wound healing.