(LML) SW Filaments

Leprosy Mailing List – August 7,  2013 

Ref.:    (LML) SW Filaments

From:  Dr. Grace Warren, Sidney,  Australia

---

 Dear Pieter,

 

I have just received this letter asking for the  Filaments.  Yes there has always seemed to be problems in getting the filaments. Forty years ago it was very hard to get them regularly. 

 

I know that ideally they are desirable but for many  years we worked very well by instructing our  assistants to do their sensory testing using the ball point pen,  depressing it till there was a tiny dent about 0.5cm diameter (note editor: the present advice is a minimal touch with a dent of even less than 0.5 cm and without any colour change from red to white due to the pressure – basically just the weight of a BIC ballpoint pen without any additional pressure!). This is a ball point pen so not a pin prick so is really only a measure of the  pressure.  I am sure  that these days most P.Ws and staff do have ball point pens so its teaching and use eliminates the need of purchasing  another excetr.

Yes I know that ideally we would like to have variations in  the strength of the filaments entered but basically  it is the fact of is sensation adequate to feel or not  and most  clinics do not have time and staff to do the full details of hands and feet. Very nice if one is doing some sort of trial but not necessary for routine clinics etc.,   So all respects, but can we teach the use of what is  simple but  effective, and adequate for most records.

By all means use the filaments if they are available but Please teach that workers can manage  without them an still keep adequate records of nerve involvement.,

 

 With respect,

 

Grace  Warren
Previouslty adviser in Leprosy and Reconstructiuve Surgery, for The Leprosy Mission in Asia

---

LML - S Deepak, B Naafs, S Noto and P Schreuder
The link for the LML archives is http://www.aifo.it/english/leprosy/mailing_list/index.htm

Check the LML blog at: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com