Author: Dr. Wander
Date: 11/25/2005 8:19 pm PDT
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I'd like to first address the issue of Betadine. When I was first trained, Betadine was used for everything from pre-op scrubs, to wound care, to post op dressings. However, Betadine has been proven to be cytotoxic to fibroblasts and inhibits healing. Additionally, it dries wounds, and the new paradigm in wound healing is all about moist wound healing, not drying out wounds. Therefore, in my practice, Betadine is not used on post operative wounds, especially full strength. In my practice, Betadine is limited to a pre-op scrub.
I do not place any limitation on activities on my patients following chemical matrixectomy. Although activity may be painful, there is little damage that can be done to the area with too much activity. If the patient over does it, they will usual self limit themselves when the area becomes tender. Physiologically, there's not much damage that can be done, and I allow students to go back to school immediately and adults to return to work immediately. Obviously if a patient is a soccer player, it may take a longer time and I let the patient return as soon as comfort dictates.
I believe that true value of soaking is over stated, and 1-2 weeks is more than enough. I don't allow my diabetic patients to soak, and they heal just as well ( I only perform the procedure on diabetic patients under excellent glucose control with adequate peripheral circulation).
The phenolization/chemical matrixectomy is an excellent procedure and in my experience the limitations post operatively are basically dictated by the patient's comfort level. There is very little damage that can occur, and when a patient is comfortable with an activity, they have my blessings. |
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