NEWSWORTHY NOTES FROM PM NEWS

NECESSITY OF SINGLE-USE BURS

PM News Reader Query: Standard of Care for Electric Debridement of Nails
What is the current standard of care in podiatry with regard to use of electrical drills for dystrophic toenails? Are podiatrists still doing this? If so, are the drill bits individually sterilized and used only once? Is the use of drills to debride dystrophic toenails still taught in the podiatry schools?

Response from PM News’s Barry Block, DPM, JD
A segment of an on-topic article from JAPMA has been forwarded to me by a PM News reader.  We welcome any insights or comments from our readers.

Cleaning, Disinfection, and Sterilization of Podiatric Medical Instruments

“Given the challenges with cleaning, disinfection, and sterilization of podiatric medical instruments seen in these outbreaks, disposable, single-use instruments and devices should be used whenever possible and disposed of immediately after use in accordance with state and local medical waste regulations. All reusable patient-care instruments and devices used must be first cleaned and then disinfected or, preferably, sterilized before use to prevent patient-to-patient transmission of infectious agents.”

Response from Foot DocPreneur’s David Zuckerman, DPM

I refer you to the OSHA standards for sterilization of burs that state that burs are considered sharps and should be discarded and not sterilized after each patient. For example, VA Podiatry clinics discard nail burs after each podiatry patient. It appears from this research there may be potential OSHA violations if you try to sterilize nail burs twice.
Q: What are the guidelines for sterilizing dental burs, according to OSHA?
A: Since sterilization of instruments is not an employee health issue, OSHA does not provide guidance for sterilization. However, since used burs are a contaminated sharp, employees must wear the appropriate personal protective equipment when handling them after patient care. Like other contaminated disposable sharps, used burs should be discarded into sharps containers.(1) Because dental burs are difficult to clean and are degraded by the sterilization process, dental offices should consider making burs a single use disposable item.
Reference: 1. OSHA. 29CFR 1910.1030. Bloodborne Pathogens, Final Rule.

MICRO-DRILLING STUDIES

Rapid Treatment of Subungual Onychomycosis Using Controlled Micro Penetration and Terbinafine Solution
August 2016 | Journal of Drugs and Dermatology | Volume 5 | Issue 8
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An open comparative study of nail drilling as adjunctive treatment for toenail onychomycosis.
March 2016 | Journal of Dermatological Treatment | Volume 27 | Issue 5
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PRESS RELEASES

Podiatrists Are Now Able to Utilize Micro-Drill Made in the U.S.
Foot DocPreneur Teams with PathScientific to Provide Podiatry with American-Made Technology.
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