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Hello I am a podiatrist student. I have an a bit silly question: any technique for successful removal of HD ? I know this needs more practice and experience, but I'm just frustrated I can't do it well most of time (my patients still felt a bit painful). I can see minor trace left , but i just don't dare go further after several times end up with bleeding.

 

Hello Hviewer,
I would suggest you speak to your tutor about this and ask for some more practical help.

regards

Catfoot

 

HViewer

Catfoot is right, ask your tutor to demonstrate - although this process requires skill and more than anything - practice and more practice plus watching an expert!

As a fairly new grad myself, I cannot stress enough how grateful I am to those (you know who you are!) who allowed me to simply watch an expert at work ! There is no 'one' way although ultimately the aim is for speed combined with care, precision and grace - it involves a deftness of hand and assessment of the skin of THAT particular patient - as what works for one will simply not work for another!

If their skin is particularly fragile (elderly or slightly ischaemic, or they are on Warfarin) or the HD is 'neuro-vascular' and therefore exquisitely painful - the depth needed to totally enucleate is different depending on the patients pain threshold - sometimes its not possible to totally remove it all. Equally, if the core of the HD is left behind through inadequate technique, the patient will still experience the pain, and often be back in complaining and needing another (free) appointment or taking up a scarce NHS emergency appointment!

I used to practice on fellow pods and family, whose skin was more resilient/forgiving so that when I was flying solo I was able to slowly improve on my speed and technique - using the blade at an angle that scooped the core out say, clockwise from 6 to 1 and then anticlockwise to finish - with the tip hardly moving (to avoid haems) but the distal end of the blade scooping the sides of the conical HD !

Honestly, if you watch enough people do this deft movement (howsoever they do it) - you will find your own particular way and start to enjoy hearing the grateful comments from patients leaving your clinic without pain and singing your praises (hopefully) to others!

I hope this helps a little.

Cheers

 

Thank you for all valuable advice. Really glad that I found this web on my learning journey. Here there are so many things to learn. Thrilled for that.

 

Kaelidoscope..... tis a pleasure to read your words, thanks for taking the time to be so eloquent.

Cheers