Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Reducing large areas of extravasation

Discussion in 'General Issues and Discussion Forum' started by khc10, Jan 24, 2011.

  1. khc10

    khc10 Welcome New Poster

    Members do not see these Ads. Sign Up.
    Hi all,
    I've been seeing a patient who has presented with multiple areas of extravasation with overlying callus. I had tried debriding the areas and using various orthotics and padding to reduce the intermittent pressure on those areas- however, at follow up appointments the areas of extravasation and callus were in a different place!
    Any thoughts or ideas would be greatly appriciated!!
  2. Catfoot

    Catfoot Well-Known Member

    Hi khc10,
    I have seen this manifestation on overweight patients. May I ask if your patient is adiposially gifted?

    Last edited: Jan 24, 2011
  3. cornmerchant

    cornmerchant Well-Known Member

    Hi kch10

    It is difficult to offer much help without a few more details about the patients medical history. I have seen this mainly in diabetic patients as an early warning sign of predisposition to breakdown and ulceration. I have also seen it in rheumatoid patients.
    What does seem strange is that it moves to different places when you offload with padding/orthotics.

    Have you more details?

    Last edited: Jan 25, 2011
  4. Its not that strange - with orthotics or padding you are reducing the stress on one area, but that stress does not disappear, it gets moved to other tissue.

    So maybe this patient has systemic condition which as you say they have a predisposition to breakdown - now you change the forces acting on the foot with a orthotic or pad. So the effected area gets less stress, but now others areas get more and then breakdown.

    Your chasing your tail.

    So maybe back to the Dr for blood tests for systemic conditions that may cause skin to breakdown

    my 2 cents
  5. cornmerchant

    cornmerchant Well-Known Member

    We obviously lack enough background information on this, but if padding is being used to offload high pressure areas and then produces high pressure in other areas, in my book that pad is faulty.The point of deflecting pressure is to diffuse it over larger areas thus reducing the risk of breakdown.

    It would be helpful to see some pictures kch10.

  6. khc10

    khc10 Welcome New Poster

    Thanks for your quick replies everyone!
    The patient in question is indeed obese, but has no known medical conditions. When the areas of callus with extravasation have been debrided down the skin beneath is in good condition.
    However, I think the idea of asking the GP for blood tests is a good idea and most likely what I will try next.
    Also, its a fair point that the padding may be incorrect- i'll have to put some serious thought into my next move if i choose to try padding again :)

    Thanks everyone!

Share This Page