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Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial.

Landorf KB, Morrow A, Spink MJ, Nash CL, Novak A, Potter J, Menz HB - Trials (2013)

Bottom Line: The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention.The benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement.However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Podiatry, La Trobe University, Melbourne, Australia. k.landorf@latrobe.edu.au

ABSTRACT

Background: Plantar calluses are a common cause of foot pain, which can have a detrimental impact on the mobility and independence of older people. Scalpel debridement is often the first treatment used for this condition. Our aim was to evaluate the effectiveness of scalpel debridement of painful plantar calluses in older people.

Methods: This study was a parallel-group, participant- and assessor-blinded randomized trial. Eighty participants aged 65 years and older with painful forefoot plantar calluses were recruited. Participants were randomly allocated to one of two groups: either real or sham scalpel debridement. Participants were followed for six weeks after their initial intervention appointment. The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention.

Results: Both the real debridement and sham debridement groups experienced a reduction in pain when compared with baseline. Small, systematic between-group differences in pain scores were found at each time point (between 2 and 7 mm favoring real scalpel debridement); however, none of these were statistically significant and none reached a level that could be considered clinically worthwhile. Scalpel debridement caused no adverse events.

Conclusions: The benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement. When used alone, scalpel debridement has a limited effect in the short term, although it is relatively inexpensive and causes few complications. However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions.

Trial registration: Australian Clinical Trials Registry (ACTRN012606000176561).

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Related in: MedlinePlus

Comparison of pain scores over time between the real debridement group and the sham debridement group. Values are means (SD).
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Figure 2: Comparison of pain scores over time between the real debridement group and the sham debridement group. Values are means (SD).

Mentions: Compared with baseline, both groups experienced improvements in pain immediately post-intervention, and at one and three weeks post-intervention (Table 2). When comparing raw pain levels following intervention, the real debridement group had lower mean pain scores than the sham debridement group, except at weeks five and six post-intervention, where pain scores were essentially the same (Figure 2). Evaluation of Figure 2 indicates a small, systematic difference in pain scores between the two groups from immediately post-debridement through weeks one to four. However, there were no statistically significant differences at any time point (Table 2). The largest mean difference between the groups, at one week post-intervention, was -7.2 mm (favoring the real debridement group).


Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial.

Landorf KB, Morrow A, Spink MJ, Nash CL, Novak A, Potter J, Menz HB - Trials (2013)

Comparison of pain scores over time between the real debridement group and the sham debridement group. Values are means (SD).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750246&req=5

Figure 2: Comparison of pain scores over time between the real debridement group and the sham debridement group. Values are means (SD).
Mentions: Compared with baseline, both groups experienced improvements in pain immediately post-intervention, and at one and three weeks post-intervention (Table 2). When comparing raw pain levels following intervention, the real debridement group had lower mean pain scores than the sham debridement group, except at weeks five and six post-intervention, where pain scores were essentially the same (Figure 2). Evaluation of Figure 2 indicates a small, systematic difference in pain scores between the two groups from immediately post-debridement through weeks one to four. However, there were no statistically significant differences at any time point (Table 2). The largest mean difference between the groups, at one week post-intervention, was -7.2 mm (favoring the real debridement group).

Bottom Line: The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention.The benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement.However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Podiatry, La Trobe University, Melbourne, Australia. k.landorf@latrobe.edu.au

ABSTRACT

Background: Plantar calluses are a common cause of foot pain, which can have a detrimental impact on the mobility and independence of older people. Scalpel debridement is often the first treatment used for this condition. Our aim was to evaluate the effectiveness of scalpel debridement of painful plantar calluses in older people.

Methods: This study was a parallel-group, participant- and assessor-blinded randomized trial. Eighty participants aged 65 years and older with painful forefoot plantar calluses were recruited. Participants were randomly allocated to one of two groups: either real or sham scalpel debridement. Participants were followed for six weeks after their initial intervention appointment. The primary outcomes measured were the difference between groups in pain (measured on a 100-mm visual analogue scale) immediately post-intervention, and at one, three and six weeks post-intervention.

Results: Both the real debridement and sham debridement groups experienced a reduction in pain when compared with baseline. Small, systematic between-group differences in pain scores were found at each time point (between 2 and 7 mm favoring real scalpel debridement); however, none of these were statistically significant and none reached a level that could be considered clinically worthwhile. Scalpel debridement caused no adverse events.

Conclusions: The benefits of real scalpel debridement for reducing pain associated with forefoot plantar calluses in older people are small and not statistically significant compared with sham scalpel debridement. When used alone, scalpel debridement has a limited effect in the short term, although it is relatively inexpensive and causes few complications. However, these findings do not preclude the possibility of cumulative benefits over a longer time period or additive effects when combined with other interventions.

Trial registration: Australian Clinical Trials Registry (ACTRN012606000176561).

Show MeSH
Related in: MedlinePlus