Leprosy mailing list – August 15th, 2005
Ccn:
all.
Ref.:
The neglected issue of recurrent plantar ulceration.
From: H
Srinivasan, Chennai, India.
Dear
Dr Noto,
I want to bring an important
but hardly ever discussed issue to the notice of all persons dealing
with leprosy-affected-persons, and that is the problem of
prevention of recurrent ulceration, particularly in the foot.
The most
common reason for persons cured of leprosy seeking medical
assistance is repeated plantar ulceration. Even during pre-integration
days (the so-called "golden age" of leprosy, when patients
were said to have been cared for), apart from handing over
dressings (and providing antibiotic therapy if felt necessary or as a
routine) and some kind of "protective" footwear, hardly
anything was done for this problem. Of course, the patients were told
not to walk as 'health education' (without telling them how to manage
life without walking).
Actually, with
the existing knowledge and experience, it should be possible to
prevent recurrent plantar ulceration in almost all cases.
Unfortunately that has not been happening as this knowledge has not
percolated to the surgical specialists like orthopaedic, plastic and
rehabilitation surgeons and caught their attention.
We need to make
pointed efforts to bring this knowledge to the concerned speciality
training programmes before people who have expertise in this area
disappear from the scene. This work should be taken up on a
priority basis in the present situation.
H. Srinivasan
