Effectiveness of Three Scalpel Debridement Techniques on Painful Callus in Older People

Garcia, Caleb Araguas; Soler, Francisco Corbi

doi:10.7547/17-183

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…These results cannot be directly compared with other studies on the subject as this project is the first one comparing all treatment combinations with scalpel debridement alone for IPKs. However, pain alleviation after callus debridement including IPK, is reported for short and medium terms and are consistent with our results [15, 23, 50].…”

Section: Discussionsupporting

confidence: 93%

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

Mercier

Blanchette

Cantin

et al. 2021

Journal of Foot and Ankle Research

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Background An intractable plantar keratoma (IPK) is a conical thickening of the epidermis’ stratum corneum and a common cause of foot pain which can have a significant, detrimental impact on the mobility, quality of life and independence of individuals. Conservative treatments are currently offered to patients with IPK, but they are unsatisfactory since they do not offer a sufficient or permanent reduction of symptoms. The purpose of this study was the evaluation of the feasibility, safety and effectiveness of innovative treatments for intractable plantar keratoma (IPK). Methods A randomized single blind trial with 40 patients divided with block randomization in four parallel groups was conducted to compare treatment combinations: conservative sharp debridement only or sharp debridement with needle insertion, physiological water injection or lidocaine injection. All patients obtained the same treatment four times at a four-week interval. At each visit, visual analog scale (VAS), Foot Function Index (FFI) and IPK size were evaluated. VAS and FFI were also completed at a six and twelve-month follow-up. Results Our findings in regards to feasibility demonstrated recruitment challenges because of the anticipated pain that would be provoked by needle insertion may not be worth the potential pain relief compared to debridement alone from the patient’s perspective. This was also the principal cause of drop out. Our preliminary results show no main effect of group for any of the clinical outcomes: pain felt on VAS, FFI score, IPK’s size (p > 0.05). However, the analysis revealed a statistically significant effect of time on VAS (p < 0.001), FFI score (p < 0.001) and IPK’s size (width and depth (p < 0.001); length (p = 0.001)), but no group x time interaction was found (p > 0.05). Conclusions This study demonstrates that IPK treatment consisting of sharp debridement with needle insertion, physiological saline water injection or lidocaine injection is feasible and safe. There was a non-statistically significant trend toward diminishing pain intensity compared to scalpel debridement alone. The pain provoked by needle insertion and injection treatments must be addressed with a scientifically proven protocol to make it more comfortable for patients before these treatments could be considered in further studies. Trial registration ClinicalTrials.gov, NCT04777227. 2 March, 2021 - Retrospectively registered (All participants were recruited prior to registration).

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Section: Discussionsupporting

confidence: 93%

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

Mercier

Blanchette

Cantin

et al. 2021

Journal of Foot and Ankle Research

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“…11 Research by Redmond et al in 1999 also found no significant relationship between age and resolution of callus and clavus, both measured by lesion resolution after excision and Visual Analog Scale (VAS). 12 Research by Güngör et al in 2014 and Stephenson in 2016 also found no significant relationship between the location of the lesion and the resolution of the lesion. Güngör et al, in their retrospective study, found that 12 out of 17 clavus and callus patients had a complete recovery with no more clavus lesions on the hands and feet without any difference in healing in the two locations.…”

Section: Discussionmentioning

confidence: 98%

Patient preferences for surgery or non-surgery for the treatment of clavus and callus at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

et al. 2022

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Background: Clavus and callus are common hyperkeratotic lesions that can be very painful and affect the quality of life. The clinicians are faced with various factors affecting the resolution of the lesion, and no treatment has been considered ideal. Surgical has been preferable to conservative treatment but is still more likely to increase patients' desirability due to great discomfort. This study aims to evaluate the factors contributing to the resolution of callus and clavus. Methods: Retrospective analysis was done on 25 medical records of patients who met the inclusion criteria. Factors contributing to the lesion resolution were identified and analyzed using the SPSS version 17 program. Result: Among 25 (33.7%) patients recruited for the study, 13 were (52%) male and 12 (48%) female. The most common types of lesions were clavus (20 [80%]). In both cases, the distribution of lesion locations was mostly found in the lower extremities (20 [80%]). Excision was performed in 21 cases (84%), and 20 patients (80%) achieved resolution. Treatment modalities were found to be a factor that had a significant relation to the resolution of the lesion after receiving treatment (p = 0.003; Spearman test). Conclusion: Treatment of callus and clavus has shown satisfactory results in our center. Excision was found to be the most preferred method, with 80% resolution observed during 1 month. The treatment choice was found to be significantly related to the resolution of the lesion after receiving therapy.

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“…The requirement for competent scalpel skills in Australian podiatry graduates has never been higher. Our ageing population has an increased prevalence of painful foot lesions, including callus and corns [ 2 ], which when managed well (including scalpel debridement) can assist in reducing pain [ 3 ], ultimately improving quality of life [ 4 ]. Furthermore, the non-traumatic lower limb amputation rate has risen 30% in the last ten years [ 5 ], with diabetes-related foot disease resulting in 4,400 lower extremity amputations and 1,700 deaths every year [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

An exploration of the use of 3D printed foot models and simulated foot lesions to supplement scalpel skill training in undergraduate podiatry students: A multiple method study

et al. 2021

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Background Podiatrists regularly use scalpels in the management of foot pathologies, yet the teaching and learning of these skills can be challenging. The use of 3D printed foot models presents an opportunity for podiatry students to practice their scalpel skills in a relatively safe, controlled risk setting, potentially increasing confidence and reducing associated anxiety. This study evaluated the use of 3D printed foot models on podiatry students’ anxiety and confidence levels and explored the fidelity of using 3D foot models as a teaching methodology. Materials and methods Multiple study designs were used. A repeated measure trial evaluated the effects of a 3D printed foot model on anxiety and confidence in two student groups: novice users in their second year of podiatry studies (n = 24), and more experienced fourth year students completing a workshop on ulcer management (n = 15). A randomised controlled trial compared the use of the 3D printed foot models (n = 12) to standard teaching methods (n = 15) on students’ anxiety and confidence in second year students. Finally, a focus group was conducted (n = 5) to explore final year student’s perceptions of the fidelity of the foot ulcer models in their studies. Results The use of 3D printed foot models increased both novice and more experienced users’ self-confidence and task self-efficacy; however, cognitive and somatic anxiety was only reduced in the experienced users. All changes were considered large effects. In comparison to standard teaching methods, the use of 3D printed foot models had similar decreases in anxiety and increases in confidence measures. Students also identified the use of 3D foot models for the learning of scalpel skills as ‘authentic’ and ‘lifelike’ and led to enhanced confidence prior to assessment of skills in more high-risk situations. Conclusion Podiatry undergraduate programs should consider using 3D printed foot models as a teaching method to improve students’ confidence and reduce their anxiety when using scalpels, especially in instances where face-to-face teaching is not possible (e.g., pandemic related restrictions on face-to-face teaching).

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Effectiveness of Three Scalpel Debridement Techniques on Painful Callus in Older People

Cited by 4 publications

References 25 publications

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

Effectiveness of saline water and lidocaine injection treatment of intractable plantar keratoma: a randomised feasibility study

Patient preferences for surgery or non-surgery for the treatment of clavus and callus at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

An exploration of the use of 3D printed foot models and simulated foot lesions to supplement scalpel skill training in undergraduate podiatry students: A multiple method study

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