Application and assessment of microfibrillar collagen hemostat in heel spur surgery: a preliminary study.

Microfibrillar collagen is described. The method of application and use on the exposed surface of cancellous bone encountered in heel spur surgery, herein defined as a resection of the inferior calcaneal exostosis with plantar fasciotomy, is discussed. Microfibrillar collagen's chief effect on cancellous bone is rapid, dramatic cessation of bone bleeding. It was assessed in terms of its effect on postoperative pain, quantitative subcutaneous hematoma formation, and edema. Although patients initially experienced increased discomfort during the first 24 hr. postoperatively, their edema, subcutaneous hematoma formation, and, more dramatically, need for narcotic analgesics was significantly reduced in the microfibrillar patient group when compared to patients having the same surgical procedures without the microfibrillar collagen intraoperatively. There were no postoperative complications encountered after the use of microfibrillar collagen in any of the 23 cases.

Pain reduction with transcutaneous electrical nerve stimulation after foot surgery.

The authors provide statistical evaluation of the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative pain. A comparison was made to intramuscular (I.M.) and oral (P.O.) analgesic medications required by patients after foot surgery, both with and without the benefit of a TENS unit. Sixty-five postoperative patients who had TENS applied were randomly selected, and their I.M. and P.O. analgesic medications were recorded. This group was compared to a group with the same number of patients from 1 year previously. Patients in the second group were of similar ages and had similar procedures, but without the use of TENS. Compiled data were organized by age and osseous procedure group and compared in both bar and linear graphs. Significant reduction was seen in P.O. analgesic medications for all procedures and ages, and to a lesser extent for I.M. analgesics with an overall patient analgesic medication reduction of 74.9%.