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Post by blinda on Apr 13, 2009 18:55:40 GMT
Hi All,
I`m putting a paper together on heel fissures and efficacy of tissue adhesive for promoting wound healing, on this weight bearing site.
I would be very interested to hear if anyone has tried this application which is commonly used in laparoscopy and closure of wounds and lacerations in A & E.
Cheers, Bel
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Post by Admin on Apr 14, 2009 5:44:25 GMT
Hi Bel,
Haven't tried it myself for heel fissures. You may also be interested in chasing up anecdotal evidence of the use of superglue for the treatment of injuries caused to dogs in illegal dog-fights.
Also anecdotally, I've always found that physically closing and holding the edges closed with tape/steri-strips works well in aiding healing. Of course the common associated factors (overweight, dry skin, unsuitable footwear (esp slingbacks) must also be addressed to achieve a permanent resolution.
Regards,
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Post by Martin Harvey on Apr 14, 2009 20:42:12 GMT
Has anyone tried suturing under a tibial block for deep heel fissures?
Any thoughts?
Cheers,
Martin
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Post by Admin on Apr 15, 2009 6:08:20 GMT
Hi Martin,
Unless underlying factors are dealt with I don't see how suturing could work long-term.
If there are no underlying factors (ie they've already been dealt with) then simple taping should do the trick.
Only anecdotal I'm afraid - would make a good research project for someone though!
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Post by blinda on Apr 15, 2009 17:27:22 GMT
Hi David & Martin, Thanks for the replies. Didn`t take delight in reading a few stories about this..... Absolutley, causative factors have to be addressed/explained to pt. I have used Haelan tape in the past on deep fissures (these contain the steroid fludroxycortide) but need to be reapplied every 24 hrs. These were initially indicated for dry, scaling lesions, not intended to bind tissue, so the occlusive benefits are limited in comparison to the glue, although useful if localised bacteria infection is suspected. I see where you are coming from here Martin, as sutures can withstand holding tissues together under weightbearing. However, when you consider that adhesive is now being utilised as preference over suturing/staples in many hospitals, in addition to painless application i.e. no anaesthesia required, it is worth considering. Not that I`m against tib blocks, in fact I`m hoping to carry out more in the near future see PodA; www.podiatry-arena.com/podiatry-forum/showthread.php?t=25720Gimme a few months and you just might be reading one! Cheers, Bel
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