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Thread: callous/pressure area

  1. #1

    callous/pressure area

    (typed by melissa's mom)

    melissa's been having a problem with her leg tipping out to the side for some time now so her foot is tipped in her shoe while she's in her chair. she moves around a lot because of her pain so the side of her foot rubs against her shoe.

    this has been going on for a while now and a callous has formed on the bottom of her foot. she can feel her feet so it has been bothering her but we really haven't worried about it until the last couple of days.

    the callous has gotten larger and more painful so she isn't able to wear her shoe. we are having to try to balance a pillow on her footrest because she is afraid that it will form a pressure sore.

    do you have any suggestions on ways to help heal it? we have been putting lantiseptic on it to keep it from drying out, but we aren't sure if that is the right thing to do.

    Life is a lesson you learn when you're through.

  2. #2
    Super Moderator Sue Pendleton's Avatar
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    In the short term I'd put a rolled up towel on the side of Melissa's leg that turns out. That will keep it in position until you can arrange a seating clinic to have her cushion and posture looked at. I have the same problem but to a lesser extent and try to wear high top tennis shoes when at home to keep my foot and ankle in line. I have only had a callous on the bony area below my big toe and it acted like a regular callous...dried, peeled and went away.

  3. #3

    Other suggestions

    In addition to Sue's suggestions, I would recommend looking at her position in bed. Generally this posture in the wheelchair is due to incorrect bed positioning. If the leg is allowed to roll outwards (externally rotate) in bed, you can develop a contracture in this position. Then when you sit, the foot also externally rotates (and generally the leg will also abduct so that the knees won't come together).

    The way to avoid this is to use a trochanter roll or leg positioning device in bed to keep the toes always pointed to the ceiling (when lying on your back).

    Otherwise in the chair, you can provide temporary foam padding taped in place on the chair anyplace that rubs, but getting a seating re-evaluation would be most important. Until then the callous really has a function, and removing it could cause skin breakdown and a pressure ulcer.

    (KLD)

  4. #4
    (typed by melissa's mom)

    thanks sue and kld.

    melissa has a new wheelchair man and is in the process of getting a new wheelchair, so hopefully her problem with her leg turning out will be solved. she already wears high top tennis shoes, so that's taken care of.

    we're still wondering what we should be doing about the callous. should we be putting something on it i.e. some kind of ointment and some kind of bandage or do we want it to dry out? we have been told that duoderm would be good for a bandage. is that something that you would recommend?

    Life is a lesson you learn when you're through.

  5. #5

    callous on foot

    Melliska - You have commented that you have tried to keep the callous from "drying out". Can you describe the area more? Is it simply calloused, hard skin or is there any inflamation or moisture associated with it? Is it so dry that there is concern that it might crack and bleed? KLD has noted that its presence is beneficial but since you have noted a change in the last two days, you should be certain that nothing is occuring underneath the callous that may lead to breakdown. It is important to note that breakdown can occur from a deep base beneath an area and work its way up to the surface or begin on a surface and erode downward. Often the former isn't discovered until there is considerable damage.

    I would suggest that you contact your primary doctor to determine the next step beyond changing the wheelchair and seating. Do you have any of the lambskin or soft padded boots that may have been used while you were in rehab? This would cushion the foot as well as provide a more comfortably surface for your foot. CRF

  6. #6
    Super Moderator Sue Pendleton's Avatar
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    If the callous is on the bottom of the foot and a piece of duederm can be cut to go all the way around it but with a hole cut for the callous to hide in then you might try that. I always use a moisturizer on my feet everynight and nothing has really goten hard to where I worry about it cracking and bleeding. To me it just makes sleeping a lot more comfortable because my feet are very sensitive and even well washed sheets drive me nuts if my feet are dry. I also don't sleep on my back but I'd go along with the nurses if I did--use the bunny boots. I always sleep on my sides and that seems to give my feet a break.

  7. #7
    i had a small area of dry skin that i (stupidly) picked of. It left an area of pink skin which i didn't protect and ended up with a pressure sore. Be careful when this dry skin comes away to pad this area and keep an eye on it, i wish i had!
    Also i would try to stretch the foot for her a couple of times a day if she can't put her foot in a 90o angle on the foot plate, just so she doesn't develop any degree of drop-foot.

  8. #8

    Callous/pressure area

    tikit2ride - Thank you for sharing that excellent advice. CRF

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