The effectiveness of salicylic acid plasters compared with 'usual' scalpel debridement of corns: a randomised controlled trial
Lisa J Farndon, Wesley Vernon, Stephen J Walters, Simon Dixon, Mike Bradburn, Michael Concannon and Julia Potter Journal of Foot and Ankle Research 2013, 6:40 doi:10.1186/1757-1146-6-40
Have treated many patients after they have used corn plasters interdigital corns and the breakdown of skin can only be described as horrific. Would def only recommend under supervision! :)
I get a shudder down my spine every time a neuropathic diabetes patient tells me that they had gotten a corn from wearing poor shoe wear and decided they would 'fix' it with a corn pad. ulcer treatment generally follows. I think diabetes is a massive contraindication for the use of corn pads.
if a patient wishes to use them they should be warned about incorrect use. Scalpel technique and better shoe wear/deflection padding is a sure way of corn formation reduction in my opinion.
How do you measure the 'size' of a corn?
If you measure it before any str.C is removed the edge of the thickened str.C can be relatively indistinct?
Do YOU reduce the overlying callus and measure the 'diameter' of the nucleus?
Assuming that the corn is not round, how many measurements do you take? Do you average them? If so how?
Is the depth of the nucleus important? How do you measure the depth of the nucleus? How many measurements do you take? How do you average them?
Do you take a volumetric measurement of the nucleus? How do you do it?
I am sure it's pretty simple but possibly not as simple as me.
I'm not keen on any patient using corn pads even under "supervision" what ever that means, but on the other hand my patients were always high risk++. I saw disasters with corns removed by scalpel as well. The study appears to have been conducted on healthy adults and I suppose liberties can be taken with few expected complications. Personally I would like graphic warnings printed on corn pad packets similar to that on cigarette packets. But if patients took notice of cigarette packet warnings they perhaps wouldn't have the ill health in the first place that puts them at risk when using corn pads!
Ros
That is not my experience of any significant corn, ie one that brings the patient back to see the podiatrist at a maximum interval of two months. In my experience the percentage completely resolved at three months approaches 0%.
At best fiddling with the stratum coreum is only ever going to be a small part of any comprehensive, effective, curative management of corns or callus.
Did the researcher give a rationale as to why the use of salicylic acid should give 'superior' results to reduction of the excessive str.Corneum?
Is trying to cure a corn by reducing the str.corneum a bit like trying to cure baldness by cutting the hair or like trying to cure acne by picking the spots?