Abstract

Objective. To compare two techniques of Cryotherapy for clinical effectiveness, pain, and effect on the quality of life of patients when treating plantar warts. Method. A quasi-experimental matched subject study was conducted. Twenty subjects with a newly diagnosed plantar wart were recruited. Subjects were matched for confounding variables in relation to site of lesion, gender and age, and were divided into two groups. Group A (n=10) were treated using the CO2 Gun & Probe technique whilst Group B (n=10) were treated using the Portable N2O pressurized spray technique. The plantar warts were measured at time 0 (before treatment) and Time 1(3 weeks following treatment) using a metre ruler. The Foot Function Index and the Visual Analog Scale for pain assessment during treatment were also used. Results. The study found no significant difference in the effectiveness (p= 0.387), pain caused during treatment (P=0.855) and FFI scores (p=0.172) for total change in QOL in the study group when comparing both treatments. However, comparison of the mean scores showed that the CO2 Gun & Probe method was slightly more effective in reduction of size. Pain during treatment was almost identical when using both techniques. The FFI scores on all 3 subscales (Pain, Disability and Activity Limitation) showed a larger increase in the CO2 Gun & probe method, when compared to the pressurized N2O Portable device. Conclusions. Although this study has found no significant difference between two different techniques of cryotherapy, mean differences have indicated that the CO2 Gun & Probe technique is more effective in reducing the size of the warts when compared to the N2O Pressurized Spray Technique; however the CO2 Gun & Probe technique caused a larger impact on quality of life. Recommendations from this study suggest that careful consideration is required when selecting a treatment for plantar warts and furthermore patients should be advised on the likely outcomes of each treatment before any intervention.

Highlights

  • IntroductionDespite years of medical research and literature on the subject area, high quality evidence on the effectiveness of most treatments for removal of warts is lacking and no treatment has yet been proven to be 100% effective[2]

  • Participants were eligible for the study if they were aged 18 years or over and had a plantar wart that, in the opinion of a healthcare professional, was suitable for treatment with both cryogens used in this study

  • The aim of this study was to compare differences in reduction in size, pain felt during application of treatment and change in quality of life before and after a single treatment for plantar warts using 2 different cryotherapy techniques namely the CO2 Gun & Probe technique and the Portable N2O pressurized spray technique

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Summary

Introduction

Despite years of medical research and literature on the subject area, high quality evidence on the effectiveness of most treatments for removal of warts is lacking and no treatment has yet been proven to be 100% effective[2]. For this reason, many NHS Trusts view plantar warts as a very low priority as far as providing treatments[3]. The high incidence of this condition and the associated complaints have inspired many authors to explore the available treatments for the fastest eradication of warts to relieve the patients from pain and allowing them to continue with their regular lifestyle[5].

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