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The Treatment of Verrucae Pedis Using Falknor's Needling Method: A Review of 46 Cases

Discussion in 'General Issues and Discussion Forum' started by Kevin Kirby, Apr 2, 2013.

  1. dyfoot

    dyfoot Active Member

  2. blinda

    blinda MVP

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    You either pay yer dollar, or ask the author very nicely...

    http://eprints.soton.ac.uk/363635/
     
  3. Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    I would have thought private practice is the ideal place to base clinical research - especially in areas like VP Rx. Too many theoretical academic papers have little application or relevancy in clinical practice these days and very often are no more than grandstanding by ambitious authors eager to promote their own self interest or products. Keep at it - it would be good to have a follow up paper to the original.
     
  4. house

    house Member

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Great article, I particularly liked the part:
    "the entire lesion was perforated enough to produce a beefy red wound"

    Thanks
    Rory
     
  5. dyfoot

    dyfoot Active Member

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Thanks blinda,

    Ivan sent me the article yesterday.

    Cheers,

    Brad
     
  6. Riksta

    Riksta Welcome New Poster

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Awesome work Belinda, love your logic and knowledge on this subject. Just completed my first solo VP needling last week (graduated last year), looking forward to monitoring the outcome.

    Cheers,
    Rikki
     
  7. blinda

    blinda MVP

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Farina presented this paper at the Primary Care conference this week, which stimulated a great deal of interest and discussion. Unfortunately, I was not in a position to answer some very pertinent questions, but will endeavor to make the time to do so here, in the next couple of days.

    Cheers,
    Bel
     
  8. blinda

    blinda MVP

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    See new thread;
    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=97416
     
  9. Dr.House

    Dr.House Member

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Hello,

    I am a medical student from Germany and I just registered here because I found that thread when I looked for further information about the study "The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases"

    First of all I want to thank the authors of this paper as I saw that they are active on this board.

    I find the needling approach of treating warts very interesting and logical. The success rates described in the study and in this forum look quite promising.

    My family seems to be a bit prone to warts and this is why I would like to give this method a shot. Unfortunately this method is very uncommon and unknown in Germany and I did not find anyone who offers this treatment. Despite that I want to try it.

    Where can I find any further detailed information about the correct needling technique? At first sight it does not seem to be very complicated but is it possible to get an instruction that is a little bit more detailed than the one in the study?

    Thanks for your help,

    Greetings from Germany
     
  10. Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Dr. House:

    You may want to read the Podiatry Arena thread from about six years ago Mosaic Verrucae-help with treatment from the oldest threads to the newest. I covered most of the important points of performing the technique in the initial few pages of threads. By the way, I now use a 25 gauge needle to do the needle punctures for plantar verrucae.

    Belinda Longhurst "Bel" is planning on performing more research on this technique in the near future in the UK. I'm sure she can provide you with much more information. She is a great resource on this subject.

    I have attached Falknor's original paper describing the technique and below is Belinda's paper for your reading pleasure.

    http://www.mdpi.com/2077-0383/2/2/13/htm

    Wilkommen!!:welcome:
     
  11. blinda

    blinda MVP

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Hello, Dr House

    I am on annual leave in Dalyan at the moment, but if you private message me your email address i can send you further information on needling verrucae when I return next week.

    Cheers,
    Bel
     
  12. Dr.House

    Dr.House Member

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Thanks alot Kevin Kirby for the welcome and the material,

    i will read through the thread you posted. I just started reading, it is very interesting!


    Thanks Blinda for your answer. Very cool that it is possible here to talk to the ones who made the study. ;) And great thanks for your offer about sending additional information via email. I will send you my email adress. Have a great holiday!


    Thanks a lot to both of you!
     
  13. EHirst

    EHirst Welcome New Poster

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    Hi I have ben treating verruca with needling for the past year and have a patient with several large VP but she is only 16 years old. has anyone needled anyone this young ? I was told it was not a suitable treatment for anyone under 18 ? thanks
     
  14. Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    I have treated children with verruca plantaris as young as 7 years old with needling over the past 15+ years. Why would it not be suitable treatment for anyone under 18? Whoever told you that, tell them I said "That's ridiculous."
     
  15. EHirst

    EHirst Welcome New Poster

    Re: The Treatment of Verrucae Pedis Using Falknor’s Needling Method: A Review of 46 Cases

    I will!! thanks
     
  16. Here is a case report of a nine-year-old girl that had multiple verrucae lesions on her feet and hands. I only needled two of the verrucae lesions on the right foot at the 2nd and 3rd plantar intermetatarsal spaces on July 8, 2015. I just saw her again today (July 30, 2015) for her 22 day follow-up post-needling. She has had near complete resolution of all but about three of her 20+ foot and hand lesions, and those also appear to be resolving.

    I have included the text from my original chart note from July 8, 2015. I have attached post-needling photos from July 16, 2015 and July 30, 2015 of the right foot (only 14 days between these two photos!).

    As is evident from these photos, the needling technique for verrucae plantaris, can be a very powerful technique. The Kaiser podiatric surgery resident who saw her with me on both of her visits was very impressed and can't wait to try out the technique in his own clinic.

     
  17. Dr.House

    Dr.House Member

    Great pictures Kevin Kirby!



    I am going to try the method in 3 weeks (on me), read through the thread you posted and looked through the material blinda sent me. Thanks a lot for that.

    I have just 2 questions left, I apologize if they are trivial for you:

    1. As there is no one in Germany who offers the needling technique, I decided to try it with my family doctor. For anaesthesia Post tib/ankle block is recommended. Unfortunately she has no experience with that. Is local infiltration around the lesion an option (although it is more painful)?

    2. How is the debridement before treatment done? Just with a scalpel? What is the reason for debridement and how deep do you debride?


    Greetings from Germany,

    Dr.House
     
  18. Dr. House:

    I never use a posterior tibial nerve block for verrucae needling. Rather, I always use local infiltration of local anesthetic (I use 0.5% bupivicaine) deep to the lesion preceded by about 5-10 seconds of ethyl chloride spray to temporarily freeze the skin in order to reduce the pain of injection.

    I debride the skin before the procedure with a #15 blade to the point of pinpoint bleeding before I perform the needling. The reason for the debridement before the procedure is to better appreciate the anatomy of the verrucae tissue relative to the normal tissue.

    I suppose I should do a video of the the whole procedure since it is becoming so popular these days.

    Hope this helps.
     
  19. Dr.House

    Dr.House Member

    Thanks again Kevin Kirby for your tips.

    I got needled 5 days ago and I am very curious about the results.
    We did it with local infiltration, then two lesions were needled to pin point bleeding. each lesions was punctured about 80-100 times.
    I had light post op discomfort for about 24hours.

    hope this gets the job done :drinks

    I will report in a few weeks when I will see whether the immunisation worked.

    Greetings from germany,

    Dr.House
     
  20. You will note a hard, dark colored eschar forming at the verruca needling site in about a week to 10 days. This should be debrided with a scalpel down to just before bleeding occurs in order to thin the dried-blood eschar and prevent discomfort with weightbearing activities. After this initial debridement, which I usually perform at 10 days -2 weeks post-needling, you should start noticing a gradual resolution of the verrucae. If the verruca has not resolved at 6 weeks post-needling, then it will probably not resolve. Most verruca take only about 4 weeks to completely resolve after the needling procedure is performed.

    Please keep us informed of your progress and good luck.:drinks
     
  21. blinda

    blinda MVP

  22. DaveJames

    DaveJames Active Member

  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    EVerT2?needling versus non-surgical debridement for the treatment of verrucae: study protocol for a single-centre randomised controlled trial
    Farina Hashmi, David Torgerson, Caroline Fairhurst, Sarah Cockayne, Kerry Bell, Michelle Cullen, Michael Harrison-Blount
    BMJ Open 2015;5:e009406 doi:10.1136/bmjopen-2015-009406
     
  24. Dr.House

    Dr.House Member

    Hey, I just wanted to give you all an update about my progress:

    After my first needling procedure there were no resolution of the warts. We did a second and third attempt with about 6 weeks in between. In the third attempt the treatment was done more "aggressive". we needled the two biggest warts with about 200 punctures. After that there was a bit more than pin point bleeding (although we covered the lesions with a swap I got a blood stain in my shoe, luckily I wore old ones). We never did debridement of the eschar because I always was just a few days in my hometown were the needling were done.
    About a month after the third treatmant all warts were gone :D But the areas that were needled looked a bit "elavated"/swollen for a few month. Now the areas are just a bit pink, they look almost like normal skin.

    My little sister (15 yeras old) had/has also warts on her foot. 3 to 4 warts were neeedled on one foot in one procedure. We are not shure wether the warts resolved completely but most of them are gone, but there are a few spots that look still a little keratotic. I am going to see her in a month and then we will decide wether another needling is necessary.

    Thanks for all the support done by kevin kirby and blinda :drinks

    In my opinion this is a very great technique although you may need more than one needling attempt. But in my opinion this method is more than just excision/removal of the wart. This method gives you an ammunation comparable with a vaccination. For me the process of needling and thus obtaining immunation is logical and its also explainable with the current immunology knowledge. O fcourse the immunisation is just against the HPV strain you were infected with. But the fact that all warts will probably clear if the immunisation were succesfull is worth all the effort. By the way the hpv vaccination (e.g. done with gardasil) takes also two to three doses (depends on the age).

    So in my opinion a great method that also makes sense in immunologic context.
    Keep on going!
     
  25. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Efficacy and Safety of Fire Needle Therapy for Flat Warts: Evidence from 29 Randomized Controlled Trials
    Ying Zhang et al
    Evidence-Based Complementary and Alternative Medicine
     
  26. stevewells

    stevewells Active Member

    WTF is fire needle therapy!!!!?????
     
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