Abstract
BACKGROUND
A heloma durum (HD) is a raised hyperkeratotic lesion that has a keratin plug and is mostly commonly found on the feet. The keratin plug can be deep rooted causing pain on the individual. A heloma durum can cause debilitating pain that negatively affects the quality of life of the bearer. Due to increased plantar foot pressures, the skin on the plantar aspect of the foot responds by building extra layers of skin, forming a callus. This callus is further subjected to torsional forces during daily activities, leading to the formation of a keratin plug 'nucleus', and is now referred to as a `heloma durum'. A heloma durum can also form due to blunt force trauma to the plantar foot area, leading to the formation of a keratin plug (Ahmad et al.,2023).
The aim of this study was to investigate the efficacy of deep surgical enucleation paired with hyfrecation in the treatment of a heloma durum. The 1st objectives for this study was to describe and evaluate the clinical effectiveness of this procedure by determining its success and failure rates and factors contributing to these outcomes. The 2nd objective for this study was to compare postoperative pain levels to establish the degree of symptomatic relief provided by the intervention. The last objective was to examine any improvements in the appearance of the heloma dura site following the procedure as an indicator of success or failure of the procedure
METHODS
This experimental, one-group, pretest–post-test design study investigated the efficacy of deep surgical enucleation and hyfrecation of the keratin plug procedure for heloma durum at District Clinics across Tshwane, Gauteng. The setting for this study was three district clinics, namely, Eersterus clinic, Skinner Street Clinic, and Bophelong Clinic, all located in the Tshwane District. Participants were duly screened for hypertension and diabetes mellitus, prior to undergoing the procedure, thorough history taking meant that all bases were covered and the right candidates participated in the procedure.the information letter was read to all participants and they were given an opportunity to ask questions. After the participants signed the consent form then the researcher proceeded to perfom the surgical procedure. The lesion site was cleansed with an alcohol based cleanser, the hyperkeratosis was debrided. 2% Xylotox with adrenaline was then administered around the lesion. Only 1 ampoule of 2% Xylotox was used per patient. The keratin plug was then hyfrecated, a size 15 blade on a scalpel handle was used...