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Colleagues, I would be very interested to hear of peoples experiences of using these swabs for nail surgery. With the potential for difficulty in accessing liquid phenol in the future, we are exploring the option of changing our practice and using these swabs instead.

How many people are using them? What have your clinical results been like when compared to your previous results using liquid phenol straight from the bottle etc.? Have you experienced any problems?

Regards

Stephen Moore
Head of Podiatry
NHS western Isles

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'There are no problems - only opportunities to be creative' :)

Hi Stephen

we are in the process of introducing them now they have a CE mark. Did your department use them in the end?

kind regards

lgs

We didn't introduced the swabs, shortly after posting to the web site there were difficulties with ordering the swabs without CE mark. Fortunately we have not had problems securing phenol. However, now the product is CE marked they might be worth another look.

Regards

Stephen

__________________
'There are no problems - only opportunities to be creative' :)

We hope to have them in place in the next few weeks, I shall report back :)

Stephen,

We have been using them for almost a year now.

Advantages:

1) Reduced possiblity of phenol spill.
2) Reproducible amounts of phenol applied to each patient
3) Easy to use

Disadvantages:

1) One batch of swabs were inadequately filled with phenol (this hasn't happened again)
2) Clinicians were intially resistant to their use as there is so little phenol in a properly filled swab, they thought that it wouldn't be enough to work. The guidance is that one swab is used per procedure site (3 min application), but some research suggested that even 2 mins might be enough. As a result, we are applying a different swab every 1 min (3 swabs per procedure site). This is mainly to qualm practitioners, especially when we were dealing with the dodgy batch.
3) We are going to be auditing our nail surgery re-growth rates again soon and if they are OK, I'll try to encourage the use of fewer swabs!

Therefore, the main obstacle appears to be psychological in the absence of better guidance based on clinical experience.

At the same time, we also went over to tornicots and these have now been accepted and are working much better than Esmarch / elastonet, but, again, some practitioners were initially resistant. However, a bloodless field (and, therefore, better phenol action) is being acheived much more consistently!

In short, I would recommend the swabs, but you'll probably have to take a pragmatic approach to introducing them!

Hope this helps!

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nicpod1

Stephen, I know private practitioners that use the EZ swabs and didn't find them that beneficial and the no of regrowths were quite alot. We use phenol crystals, and have discovered that the regrowths have reduced in comparison to using the liquid. They are easy to use and they liquify once in contact with skin. Mobilis sell these, they are worth trying!!!!

Hi All,

I find that using EZ Swabs results in higher numbers of cases of nail regrowth following procedures compared to using liquified Phenol, this despite using them in tandem with Tournicots at all times.

There is the problem that a single sized swab doesn't suit on all occasions. I feel that we could also do with more Phenol on the swab.

The other drawback is that there is a huge difference in price between using these and using Phenol.

Kind Regards,

Anne