Abstract
Objective: To investigate the clinical effectiveness of silver nitrate (95%) for the treatment of verruca pedis comparing professional and self-application treatments. Methods: A single-centre, two-armed randomized evaluation was conducted at a University podiatry clinic. A total of 113 participants (101 analysed) with ver- ruca pedis were included. Participants were randomized to either a clinical group, where silver nitrate was applied by a healthcare professional or a home group, where silver nitrate was self-applied. The main outcome measure was post-treatment pain, controlling for pre-treatment pain, and resolution of the verruca. Secondary outcome measures were participant satisfaction, partial reduction in the verruca and ease of use of the product. Key findings: The study showed no significant difference between home treat- ment and clinically applied treatment for the treatment of verruca pedis in either primary outcome; however, a substantive difference in resolution between groups was recorded, with 34.0% full resolution and 26.4% partial res- olution in the clinical treatment group, and 18.8% full resolution and 37.5% partial resolution in the home treatment group. Participants widely reported general ease of use of the product. All participants reported a reduction in pain as a result of the intervention. Conclusion: Silver nitrate has been shown to be a safe and effective treatment for verruca pedis, with equal success rates when compared between home and clinical applications.
Highlights
The commonest symptom of peripheral arterial disease (PAD) is intermittent claudication (IC)
Our study aimed to describe the types of Foot orthoses (FOs) currently in use across the United Kingdom (UK), Australia, and New Zealand, and to determine whether the type of FO prescribed varies between common conditions
The practice of sonography is not regulated by the HCPC, there is no requirement in the UK to hold a formal qualification, and the College of Podiatry does not define ultrasound training and competencies
Summary
The commonest symptom of peripheral arterial disease (PAD) is intermittent claudication (IC). Conclusion: There is a clear lack of evidence supporting clinical practice with gaps between evidence and guidelines in the management of acute charcot neuroarthropathy.The challenge in having a good quality research in this area are likely due to the low incidence of this condition, the long healing period and the long-term monitoring of outcomes. As clinicians of the lower limb, podiatrists are able to assess patients for signs of PAD offering treatment, advice and follow on referral to secondary care with the vascular surgery team if needed. Method: Potential participants were recruited whilst attending their retinopathy screening appointments 1 day a week over an 8 week period Those consenting had a lower limb arterial assessment using an automated device measuring ABI and pulse volume negating the need to rest the patient, and plantar light touch sensation checked, during the waiting time required for pupil dilation to occur prior to retinal screening. Conclusions: The combined screening was well-received and prevalence of undiagnosed asymptomatic PAD in this study would indicate targeted screening could allow earlier identification and intervention of potentially treatable limb and life threatening disease
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