trichloracetic acid crystals

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Although long term chiropodist I have never used these crystals mainly because of the bad press they have attracted with often awful results I have a male patient 58 yrs pretty healthy with a massive verrucae to the plantar aspect of his heel. It must measure 2 inches in circumference Ihave been using cryotherapy and 70% salycyclic acid to no avail. This wart is stubborn. Do I use these crystals the patient is fed up quite rightly. I am unsure as to their usage and would greatly appreciate other proffessionals opinions . We both want this damned thing gone!

 

Hi .. new to this arena. Read your msg re trichloracetic acid crystals. In days past I have used 40% salicylic acid paste with monocloracetic acid crystals. This will nuc anything .. esp intractable warts. Need to keep it dry for 4 days. Drain abcess and dress. Heals well afterwards. These days, I'm happy with Nitric acid

 

Thanks very much where do I get both of these preparations and can you tell me how you apply very grateful to you

 

toejo,
If you haven't been trained as to how to use these crystals I would personally leave then alone and refer your patient to a pod who can treat this VP by blunt dissection or needling under Local Anaesthetic.
Trichloracetic acid crystals are notoriously unpredicable in their action, can cause ulcers that can be excruciatingly painful, and IMO are best avoided in these days of ever-increasing litigation.
The area not to be treated needs to be well-protected with appropriate padding, the patient needs to be thoroughly assesessed for suitability and there needs to be very careful monitoring throughout the treatment.
There have been a couple of Fitness to Practice cases on the HPC website concerning patients who have lost time at work through not being able to work for a week following agressive VP treatments.
Just some well-meant advice to stop you becoming another statistic.

CF

 

I agree. Treating a lesion this large with Mono or Tri will be extremely painful! I would go with the needling procedure. Less likely hood of scaring to the blunt disscection. Perhaps!

 

I was trained many many years ago but really hated them at the time thought they were too brutal so I shall gratefully take you advice and leave them alone, Our pods do not carry out needle dissection or any other treatment than cryotherapy this darned verrucae refuses to budge and other thoughts would be welcome many many thanks:

 

Yep .. have to concur. If you've had no experience with these materials, I'd pass on to someone who has or who can offer the alternatives in other replies ... don't go too far outside your comfort zone. Contact some local colleagues to discuss this case. They will be happy to help.