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Hydrocolloid dressings and verrucae

Discussion in 'General Issues and Discussion Forum' started by MissB, May 15, 2012.

  1. MissB

    MissB Active Member


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    Hi all,

    Just wondered if anyone has had any success treating verrucae with a hydrocolloid dressing such as granuflex? Would the affect be the same as duct tape?

    I have patients who look at me like I’m crazy when I suggest duct tape!! Despite me explaining how and why it works. I suppose that when you’re paying for a service you want a treatment that sounds a bit more ‘medicinal’.

    When patients do try the duct tape method they have difficulty keeping the tape on the skin, particularly if they have sweaty feet or have used an emollient.

    My thinking is that granuflex, to these patients, is more of a ‘medical treatment’, as opposed to duct tape, which sounds like an old wives tale. It also stays on!!
     
  2. CAJ09

    CAJ09 Welcome New Poster

    I have found Compeed blister plasters a much better alternative. They are adhesive and easy for the patient to purchase. Post cryotherapy treatment they offer cushioning and protection too that I feel possibly reduces the likelihood of a blister reaction, although I usually advise application after the original padding is removed. I explain to patients to put them on a leave them until they fall off adding tape if an edge rises.There are other companies that offer a cheaper alternative too.
    :)
     
    Last edited: May 16, 2012
  3. Elizabeth Humble-Thomas

    Elizabeth Humble-Thomas Active Member

    You do know that it's all smoke and mirrors with verruccae anyway , don't you?
     
  4. Jose Antonio Teatino

    Jose Antonio Teatino Well-Known Member

    There are safer alternatives
     
  5. drsarbes

    drsarbes Well-Known Member

    "I have patients who look at me like I’m crazy when I suggest duct tape!! Despite me explaining how and why it works. I suppose that when you’re paying for a service you want a treatment that sounds a bit more ‘medicinal’. "

    I would have to agree with your patients on this one.

    So what do you tell them? (why it "works")

    Steve
     
  6. stevewells

    stevewells Active Member

    Hear Hear - how and why does it work?
    I'm looking at the screen like you're crazy !!!:dizzy:
     
  7. stevewells

    stevewells Active Member

     
  8. blinda

    blinda MVP

    See here; Duct tape does not work for VP`s

    Yeah, I`ve seen that look on Steve. Usually when I`ve said something crazy ;)
     
  9. blinda

    blinda MVP

    Yes, I`d appreciate your elaboration on that statement too, please?
     
  10. Elizabeth Humble-Thomas

    Elizabeth Humble-Thomas Active Member

    Well, I suppose I mean by 'smoke and mirrors' is that treating verruccae is a fairly baffling art. A treatment that works brilliantly on one patient may have no effect in another similar case.
    I have used just about every treatment available over the years, except laser and electro-cautery,and I still find it almost impossible to predict the outcome.
    I even bought the ultimate smoke and mirror machine, a Biogun! I felt like a snake oil salesman when I used it, but remarkably, it worked on quite a few patients.
     
  11. blinda

    blinda MVP

    I agree. Immunophysiology of verrucae is indeed complex, rendering predictive outcomes difficult to ascertain. However, there has been significant progress in the field of immunology and the humanpapilloma virus, and much work published which indicates that a cell-mediated immune response is required for resolution (see attached article below). Not really "smoke and mirrors" which is a metaphor for a `deceptive, fraudulent or insubstantial explanation or description`, according to Wiki ;)

    Hmmm, remarkable indeed. Remember this discussion you and I had not long ago?
    Cheers,
    Bel
     
  12. Elizabeth Humble-Thomas

    Elizabeth Humble-Thomas Active Member

    I just work at the foot end, trying to get best outcome for patients, not trying to score any points.
     
  13. blinda

    blinda MVP

    Not too sure what you mean by "score points". But, I firmly believe that if we are going to offer a pt a treatment regime then the onus is on us to explain the clinical reasoning, risks and benefits of every procedure. I can understand why you "felt like a snake oil salesman" when using the biogun on a viral infection.
     
  14. Elizabeth Humble-Thomas

    Elizabeth Humble-Thomas Active Member

    I am going to leave this forum, it is too aggressive for me. I'll just get back to treating my patients. Goodbye.
     
  15. Ian Linane

    Ian Linane Well-Known Member

    Het Elizabeth

    We've all been at the sharp end of comment back to us when we've said something. Have to say that so far the treatment response you've had seem quite gentle in comparison to others I've seen. Knowing some of the posters on this thread I certainly did not interpret their comments towards your posting (not you personally) in a negative context.

    Rather than leave the arena stick around. Pick up how to say the things you want to. Even I dip my toe in now and again.
     
  16. blinda

    blinda MVP

    Elizabeth,

    I apologise if you read my postings as aggressive. That was not my intention, at all.

    I`m sure you`ll agree that we all want to offer our patients the highest standard of treatment and care, based on scientific evidence and clinical experience. It is the former that requires us to keep up to date with current evidence and this is where Podiatry Arena is an invaluable source for links and references to peer reviewed published work, in addition to providing a network for our professional community offering advice and support for each other.

    There is a wealth of knowledge and experience here that we all benefit from and I would include you in that as you have had many years of valuable experience and, therefore, have much to offer our community.

    So, please accept my apology and I hope you will continue to engage here and make use of this fantastic resource.


    Cheers,
    Bel
     
  17. drsarbes

    drsarbes Well-Known Member

    "I have patients who look at me like I’m crazy when I suggest duct tape!! Despite me explaining how and why it works. I suppose that when you’re paying for a service you want a treatment that sounds a bit more ‘medicinal’. "

    I would have to agree with your patients on this one.

    So what do you tell them? (why it "works")
    =================================

    THE ABOVE COMMENTS WERE DIRECTED AT "MissB" THE ORIGINAL POST.

    I THINK WE ARE ALL STILL WAITING FOR THE EXPLANATION OF HOW DUCT TAPE WORKS AND WHY SHE HAS CHOSEN THIS Tx ABOVE ALL OTHERS.



    Steve
     
  18. MissB

    MissB Active Member

    Sorry for keeping you all waiting. I've just come back from Egypt! Yes i had a lovely time :)

    You guys have all given me something to think about! Thank you Blinda for the duct tape VP link - very informative.

    First things first...I'm not crazy! Honest.

    I had been under the impression that duct tape worked by irritating the skin - initiating an immune response, and this is what I told my patients. A lecturer of mine, as well as a few other pods had told me this, and I myself have actually had good results with the duct tape method??

    I have learnt a valuable lesson here. DON'T take what someone tells you as gospel!!
     
  19. MissB

    MissB Active Member

    PS.

    I'd like to add that I DON'T choose the duct tape method above all other treatments for VP, not at all. I only suggest duct tape if other treatment options have failed, or if for some reason they are unable to use corstics. In these situations I recommend needling (if appropriate). However, if the patient does not opt for needling or is not suitable then I suggest duct tape almost as a last resort.

    Thanks,

    MissB
     
  20. drsarbes

    drsarbes Well-Known Member

    Hi Miss B

    Thanks for the response.

    I guess using Duct Tape when all other treatments, even CORSTICS (sic) have failed, might be appropriate.

    Can I ask when is needling not appropriate if you have a difficult case?

    Also, do you think Duct Tape is more irritating to the skin then, say, canthrone or SalAcid or other caustics (or needling?)


    ===================

    One other thing..."I have learnt a valuable lesson here. DON'T take what someone tells you as gospel!!"

    May I ask .............never mind. This thread has all ready had one victim of "aggressive behavior"..... let's just move on.

    Duct tape away.....

    Steve
     
  21. MissB

    MissB Active Member

    Hi Steve,

    As a new graduate I have only had a few instances where a patient didn’t want needling. This was because they were needle phobic. Patients such as these are therefore unsuitable for needling.

    No I do not think that duct tape is more irritating to the skin than other CORSTICS (apologies for my spelling error). But caustics can burn the skin and duct tape doesn’t. Please understand that I (wrongly, it would seem) had been under the impression that duct tape was a credible treatment option – this is what I was taught.

    I don’t think you’re being aggressive, perhaps a bit ‘nit-picking’, but I don’t mind that ;)

    I joined this forum to learn. You all have so much more knowledge and experience than I do and I admire you all. I’m sorry if my comments or questions seem stupid.

    Steve, if you have any papers that you think I might find useful on the whole treatment of VP’s I will happily read them. As I said…I am here to learn.

    Many thanks,

    MissB
     
  22. drsarbes

    drsarbes Well-Known Member

    Hi Miss B
    There is no such thing as a stupid question. Stupid answers maybe! hahaha

    Interesting that they taught you to use Duct Tape as a treatment option. No comment.

    Ask on....... warts.......they come and they go, frequently whatever a patient is using at the time gets credit.

    I have found that needling is a very successful and quick healing treatment option.

    Steve
     
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