Electro-surgery

 











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All electro-surgery patients are initially seen for a 30 minute assessment appointment.


During the consultation we will take your medical history, in addition to the physical assessment. It helps us greatly if you complete a medical history form and bring it with you, copies can be downloaded here. We record details including your: name, address, telephone number, email address, date of birth, GP name and address, past and current medical history, allergies, medication, and any previous Podiatry treatment.


This is known as your minimum data set and recording it is a legal requirement. If you refuse to give us this information we will not be able to offer you treatment at our practice. We keep all the information you give us confidentially, in accordance with the guidelines laid down by the Society of Chiropodists and Podiatrists, the Health Professions Council, and the Data Protection Act (we are registered data users registered with the Information Commission).

















Electro-surgery treatment will not be provided at your first appointment, you will be invited back at a later date.


NB we normally write to your GP, after your first appointment, to inform them that you are registered with our practice and give brief details of any treatment plan. Please tell us if you do not wish us to communicate any information to your GP.



What is electro-surgery?


The term electro-surgery describes three different types of procedure which use electricity in the surgery. These are electro-cautery, electrolysis and high frequency electro-surgery. Electro-surgery is, however, generally regarded as synonymous with high frequency electro surgery.

 

The most frequent application of electro-surgery is in the treatment of cutaneous lesions. Electro-surgery, particularly electrodessication, provides a simple and rapid method for the treatment of a wide variety of benign cutaneous lesions and has become a recognised treatment modality.



Electrodessication and its use in Podiatry


Since Creswell's publication on the use of electro-surgery for the treatment of verrucae in 1984, and Smith and Morrison’s reports on its use in the treatment of chronic corns in the late 1980’s there had been few studies reported until a resurgence of interest in the late 1990’s when 3 publications appeared between January 1998 and August 1999.

 

The first of these papers, Winfield & Forster, 1998 describes a study of 65 corns treated by electrodessication with the criteria for treatment success being measurement of change in surface area of the corn, change in symptoms (pain) and level of patient satisfaction. The effect of treatment was assessed at six weeks as producing a significant reduction in pain (p=0.02), a significant reduction in surface area (p=0.01) and a high level of satisfaction. The evaluation was repeated at 52 weeks post electrodessication with the same results. Out of the 65 corns treated 33% had completely resolved, 64% had improved and 3% had failed to resolve. Later in 1998 a publication by Wilkinson & Kilmartin reassessed treatment carried out by Smith & Morrison. They looked at 61 patients (69 lesions) who were treated between 1 and 10 years previous to the date of the study. They found that 24 corns had resolved, 8 had improved and 37 had failed to resolve. They reported that there was a longer period of pain relief following treatment by electrodessication and 83% of patients were keen to have further electrodessication. A more recent publication by Lelliott & Robinson evaluated the success of treating verrucae by electrodessication. They looked at 50 patients with 70 lesions. As with the studies on heloma durum the results were positive with 100% success of treatment of verrucae on non-weight bearing sites and 63.8% success on weight bearing sites, an overall success rate of 81.9%. They suggest the lower success rate on verrucae on weight bearing sites may be the result of direct pressure and/or secondary contamination at the site.



What do we actually do?


Electrodessication is completely painless and to ensure this an injection of local anaesthetic is given before treatment begins. Then a small probe is held over the corn or verrucae, the current passes into the tissues and a small blister is formed. The roof of the blister is then removed whilst the area is still numb and a dressing applied. You will have to return in four to seven days for the dressing to be changed. Healing usually takes place in about a week to ten days (formation of the scab) depending on how much rest you take. You will have to return in four to six weeks to have the remaining scab removed.

 

The procedure should take no longer than an hour and subsequent dressings no more than 15 minutes. There may be some discomfort during the first few hours after treatment but this can be relieved by using you preferred analgesic.



Medical Insurance


Some Medical Insurance Companies are happy to recognise specialist Podiatric Surgical procedures (different to Podiatry) as a payable benefit. This includes nail and skin surgery and gait analysis.