Effectiveness of Three Scalpel Debridement Techniques on Painful Callus in Older People

Plantar hyperkeratotic lesions are prevalent foot problems in the older population, affecting 30% to 65% of people older than 65 years. Their onset is a common cause of foot pain due to the release of inflammatory mediators. Because of its simplicity, scalpel debridement is the most common treatment. We assessed how the degree of plantar hyperkeratosis debridement affects self-perception of pain in older people.

Three hundred older participants (mean ± SD age, 76.3 ± 7.4 years) were randomly allocated to receive full debridement (FD) of plantar hyperkeratoses, partial debridement (PD) of plantar hyperkeratoses, or debridement simulation (control group). Plantar hyperkeratotic pain was measured on a visual analog scale before treatment, just after treatment, 24 hours after treatment, and 7 days after treatment.

Both FD and PD of plantar hyperkeratoses of the forefoot generate similar levels of self-perception of pain just after treatment (P = .32), 24 hours after treatment (P = .15), and 7 days after treatment (P = .22). Significant differences were found between the groups treated using a scalpel (FD and PD) and the control group just after treatment (P = .04 for FD; P = .05 for PD), 24 hours after treatment (P = .03 for FD; P = .04 for PD), and 7 days after treatment (P = .04 for FD and PD).

The results of this trial suggest that there are no significant differences in pain reduction between PD and FD of forefoot plantar hyperkeratoses in older people.