34-year-old female with a three year history of painful plantar wart. This lesion had been treated 3 times previously with liquid nitrogen and electrocautery, without success. The patient was having difficulty wearing shoes comfortably and had chronic drainage from the warts.
LASER OF CHOICE: CARBON DIOXIDE
The CO2 was chosen to photovaporize this plantar wart. It has been shown that the laser is able to successfully treat intractable plantar warts that have been unsuccessfully treated by other methods of treatment. The high heat of the laser sterilizes the viral particles and prevents recurrence . The CO2 laser also seals small lymphatics and nerve endings and provides a more comfortable wound healing with less pain and edema. Patients are able to walk more comfortably in a short period of time.
A mild compression dressing is applied to the treatment area. Use a nonadherent dressing material with an antibacterial cream. Keep dressing in place 24 hours before reapplying a similar dressing daily until healed. Keep the dressing off at night as soon as minimal drainage is present. This allows faster healing to occur by allowing the wound to dry.