Plantar Wart Surgery

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Plantar Wart Surgery Perth

Plantar Verruca

What Are Verruca?

A wart, or verruca, is a viral infection that can occur primarily in the top layers of skin (the epidermis). The infection manifests as small growths or bumps on the skin that are painful to squeeze and interrupt skin lines. Often small black dots will also be visible in the raised area. Verrucae are caused by certain strains of the human papillomavirus.1 They are common in school children, adolescents and the elderly.2,3 On the foot verruca can be problematic if they occur on the bottom of the foot, in high weight bearing areas, for example the toes, forefoot or heel. Verruca can be painful and interfere with activities, they are also contagious and able to spread from one area to another on an individual or between individuals in close contact. There are several types of verruca including singular or mosaic, with larger lesions being particularly problematic on the bottom of the foot.

 

Particular subtypes of human papilloma virus are responsible for verruca on the hands and feet and require an injury or break in the skin in order to infect.1 Sometimes verruca will resolve and given enough time the body’s immune system may be able to fight the infection. However, generally it is important to have a plantar verruca examined by a Podiatric Surgeon or podiatrist, because of the thickened skin on the bottom of the foot, the specific type of virus, the risk of scaring with over treatment and the consequences to the overall biomechanics of the foot when a verruca is located in a vulnerable area.

 

Dr Pocklington can provide expert assessment and treatment of plantar verruca.

How Are Verruca Treated?

Verruca can be treated conservatively or with minimally invasive surgical correction. It is important to consider conservative treatment before pursuing surgical options, because often conservative treatment can significantly alleviate symptoms and in some cases resolve the condition.

 

Dr Pocklington is both a Podiatric Surgeon (foot and ankle specialist surgeon) and trained podiatrist with extensive understanding of the form and function of the foot before and after surgery. This includes consideration of conservative as well as surgical intervention and the overall function (biomechanics of your foot).

 

Conservative treatment of verruca involves debridement (removal) of the warty tissue through a variety of methods as well as temporary offloading to reduce pain and improve day to day activities while the verruca is resolved. Debridement can include sharp (with a scalpel) and/or the use of chemical agents to remove the warty tissue over time. Simple sharp debridement can be performed in clinic and under local anaesthetic if necessary, but the procedure is not generally painful. The goal of conservative measures is the same as surgical intervention, but the process is slower and less reliable than surgical intervention. Several visits may be needed to achieve resolution of the infection and reduction of the verruca with conservative intervention.

When Should I Consider Verruca Surgery?

If conservative measures are not able to alleviate your discomfort or if there is significant pain interfering with normal activities, if the verruca are large, or if they are rapidly spreading, surgical intervention should be considered. Verruca surgery is a straightforward procedure that removes the warty tissue directly through simple excision. The base of the lesion is then debrided and sealed using either electrocautery or chemical agents.

 

The goal of surgery is the same as conservative approaches, but instead of a staged approach simple excision surgery aims to removal all remaining infection in one procedure. In this way recovery speed is maximised and function can return to the foot as a whole. The key result is reduction or resolution of pain, resolution of the infection and a healthy return to normal activities and footwear. As a Podiatric Surgeon, Dr Pocklington is a foot and ankle specialist trained comprehensively in procedures used to treat plantar verruca and can assist you in deciding whether surgery is right for you.

What Does Verruca Surgery Involve?

Depending on the size and number of verrucae, pain levels, and locations, surgery can be performed under local anaesthetic regional block (you are awake), IV sedation (you are semi-conscious in a half-awake state), or general anaesthesia (you are unconscious). In all cases a local anaesthetic regional block is used to numb your foot, this reduces pain during and after the procedure. IV Sedation and general anaesthesia is provided by an anaesthetist. . Most procedures take between 10 and 20 minutes depending on the number and size of verrucae.

 

Surgical removal of a verruca involves cutting the topmost layers of skin (epidermis) where the verruca has developed. The deeper layers of skin (the dermis) are not injured during this process. As a result, scarring is rare. The warty tissue is removed with a curettage and the base of the wound sealed with either electrocautery or chemical agents. Sutures are generally not required and the wounds are covered with a sterile dressing. All surgical procedures have advantages and risks that Dr Pocklington will discuss with you in detail prior to your surgery.

Care and Recovery After Surgery?

Verruca surgery is usually a day procedure allowing you to immediately weight bear on your foot in a stiff sole surgical shoe. Occasionally people stay overnight at a private hospital and return home the following day.

 

Generally, pain relief after surgery is not necessary, but a combination of painkillers and anti-inflammatories will be available if needed. Usually paracetamol is all that is required.

 

Healing usually occurs 2 to 4 weeks after the surgery and during this time restricted activities, including time off work may be required depending on the location of the verruca. Dressings are removed after 3-4 days, giving you an opportunity to see your progress and discuss it with Dr Pocklington. Dressings are then changed regularly and instructions will be given so you can change dressings at home, if possible and convenient. Sutures are usually removed at 2 weeks if used, but this is rare. The process of healing after surgery is important and requires ongoing attention from your surgeon. Dr Pocklington will monitor your progress while you heal to ensure function is returned to the foot and your life as soon as possible.

 

Please book online to speak with Dr Pocklington about verruca surgery.

  1. Vlahovic TC, Khan MT. The human papillomavirus and its role in plantar warts: a comprehensive review of diagnosis and management. Clinics in Podiatric Medicine and Surgery. 2016 Jul 1;33(3):337-53.
  2. Kilkenny M, Merlin K, Young R, Marks R. The prevalence of common skin conditions in Australian school students: 1. Common, plane and plantar viral warts. British Journal of Dermatology. 1998 May 1;138(5):840-5.
  3. Kilkenny M, Marks R. The descriptive epidemiology of warts in the community. Australasian journal of dermatology. 1996 May;37(2):80-6.

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