Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Verrucae are probably contagious, but the pathogenic agent has not
been isolated. They sometimes disappear spontaneously, and they will
recur if their removal is not complete.
+Treatment.+ Certain chemical substances (see “_escharotics_”) destroy
tissue and can be employed with safety only after much experience.
These drugs when allowed to spread on the normal skin often occasion
painful and persistent lesions. They must therefore be applied
directly and sparingly to the growth itself and not be left in contact
too long.
The daily removal of a thin layer is possible in this way without
causing pain or erosion.
The chemical agents that are employed for the removal of verruca are
notably nitric acid, acetic acid, monochloracetic acid, trichloracetic
acid, nitrate of silver, sodium hydroxide and salicylic acid. The
treatment with these drugs is alike in all cases, with the exception
of the last three named.
The procedure, when using liquid acids is as follows: render the
growth and the surrounding parts aseptic; by means of a tapering glass
rod or a wooden toothpick, apply a drop of the acid so that it will
spread over the growth only, making certain that every part of the
outer surface has been treated. If pain becomes excessive, apply a
neutralizing agent. Dress the part with a shield that is holed-out, so
that when the foot-covering is in place there will be no pressure over
the tissues treated. This treatment should be repeated every other day
until there is sloughing at the base of the growth. The pocket
produced is drained, and balsam of Peru or some other stimulant should
be applied and held in place by an appropriate dressing. Five or six
treatments will ordinarily suffice to remove the growth.
Many practitioners find nitrate of silver a serviceable remedy in
cases of verruca. The pure stick, moistened, is gently applied to the
surface of the growth, which later becomes blackened. The patient
returns two days later when the scab, that will have formed, is
removed and the original treatment is repeated. Ordinarily from six to
ten such applications will suffice. Those who favor the use of
salicylic acid for the removal of verruca, usually apply a 60 per
cent. ointment of this drug, over the growth only, protecting the
surrounding parts with collodion or gelatine. A holed-out shield is
applied over the growth and an appropriate bandage is made to hold it
and the ointment in place. The patient is advised to return at the end
of ten days and, as a rule, when the dressing is removed, it will be
found that the growth is sufficiently loosened to admit of removal by
means of forceps and scissors.
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