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Verruca Pedis needling with IDDM

Discussion in 'Diabetic Foot & Wound Management' started by Bennepod, Sep 19, 2017.

  1. Bennepod

    Bennepod Active Member


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    Greetings.
    Anyone tried needling on IDDM clients. More specifically:
    39 year old IDDM for 29 yrs. A1c average 8. Using insulin pump.
    3 Large plantar lesions present for 10+ yrs, now painful.
    Resistant to the usual suspect treatments: Liq nitro, sal acid, duct tape, nail polish, topical antiviral (Aldara), pyrogallol, silver nitrate etc.
    RMH;
    Psoriasis
    1 episode of shingles (suspect)
    Neurologist dx of "slight peripheral neuropathy"
    Retinopathy mild.
    "Not an awesome healer"
    Primary Raynaulds.
    Healthcare worker; dietician.
    Active and otherwise in good health.
    Apart from any input on readers experiences with needling in such cases, I guess the question becomes, do multiple lower level insults to the tissue present a greater risk over time than a more significant insult for a short period?
    Many thanks.
    B
     
  2. blinda

    blinda MVP

    I have needled patients with well controlled diabetes, with success. I have also needled patients who are immune-compromised and taking methotrexate or biologics, with similar success. They have usually required at least 2 or 3 needling sessions and none of which have been described as “not an awesome healer”, which is obviously an important consideration.
    Did they heal well after the cryo and acid treatments? If so, then they will most likely be OK with needling as this creates less of a wound than those, so presents less of a risk of an adverse event/outcome.
    As with all VP tretament, you have to consider the risks and benefits if any tissue destructive treatment. If the patient is at risk if delayed healing, then a `tincture of time` may be the most appropriate.
     
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