The podiatrist's dust extraction drill is not actually used for drilling holes in the toe nail and it does not use a conventional drill bit. Cylindrical, club or pear shaped burrs are used to grind down or thin the nail.
Dust extraction drills are primarily used in the chiropody treatment of onychauxis. Onychauxis is where the toenail grows too much and becomes thickened.
Onychogryphosis occurs when the toenail becomes so thick that it starts to curve around. It is often difficult for podiatry patients to cut the toenail themselves when onychogryphosis occurs. In extreme circumstances the toenail can curve so sevrely that it looks like a claw or ram's horn. Once the majority of the onychogryphotic nail has been removed with toenail clippers, the dust extraction drill can be used to complete the treatment.
The toenail may additionally be onychomycotic. Onychomycosis is when a toenail is fungally infected.
Wet spray drills are not used on nails. They are used on soft skin. Wet spray drills are used for enucleating hard corns and are particularly suitable for enucleating neurovascular hard corns.
The Society of Chiropodists and Podiatrists has produced professional guidelines for podiatric toenail drills. The key requirements for a toenail drill are as follows:
Technical features of the dust extraction toe nail drill that should be considered include the range of speeds, direction of rotation, the amount of dust extraction / suction and the design of the handpiece.
A table showing some currently available podiatry dust extraction drills and typical specifications can be found at the bottom of this page.
Most toe nail drills have a range of possible speeds at which the drill can rotate. The range of possible speeds will depend upon the particular model of podiatry drill. The speed is usually set using dial or with increase and decrease buttons. The speed may be shown on a digital display. Some toe nail drills enable the operator to pre-set specific drill speeds.
The range of rotational speeds can vary considerably. For example, the Bentlon Podo Vacuum Drill has a speed range from 6,000 rpm to 40,000 rpm, whereas the Suda 650 Dust Extraction Drill has a range of speeds from 6,000 rpm to 8,000 rpm.
With the toe nail drill operating on a slow speed it can take a long time to grind down the nail. With the dust extraction toe nail drill operating at a very high speed the burr can slide off the nail. A drill speed of 10,000 rpm has been recommended in the Berchtold S35 Review.
Increasing the speed that the toenail drill is operating at, usually means that there will be an increase in the amount of noise made by the drill. This can make it difficult to talk to your patient.
The direction of rotation of the drill depends upon whether the podiatrist is left-handed or right-handed. For a left-handed podiatrist the direction of rotation should clockwise, for a right-handed podiatrist it should be anti-clockwise. For a busy podiatric surgery where lots of chiropodists will be operating the dust extraction drill, it is particularly important that it is possible to set the direction of rotation.
The podiatrist's drill must have a dust extraction capability. Nail debris can contain fungal spores, bacteria and miscellaneous organic material, therefore it is important that it is not inhaled by the podiatrist or the patient. Proprietary dust masks should be worn by the podiatrist and patient whilst drilling is being carried out, since they can prevent nail dust from being inhaled. However, nail dust must be removed from the air in the podiatry clinic by the dust extraction drill so that it cannot be breathed in by staff or patients during the course of the day.
The power available for the drill to suck up nail debris is particularly important. The amount of extraction or suction can be measured in litres per minute (lpm). This specification is not supplied with all models of drill, however 150 lpm and 160 lpm are given for the FiltAir Pure Drill and Hadewe Suction Drills respectively. It is useful to be able to adjust the amount of suction, since as with drill speed, increasing the amount of suction also increases the amount of noise that the dust extraction drill makes.
The toenail dust is collected in a dust bag. A podiatry drill should have a dust filter as a necessity, however a secondary dust filter will further reduce the amount of dust in the air and will provide additional protection should the dust bag splits.
A recommended feature of a podiatrists drill is an indicator, such as a light, that shows when the dust bag is full. However, in practice such dust bag full indicators are only useful as a guide. This is because changing the amount suction that the drill is operating at can make a difference bewteen whether the indicator light is on or off!
When choosing dust extraction drill it is important to find out how easy it is to change the dust bag. An awkward mechanism could result in toenail dust spilling out of the dust bag! Also, the larger the volume the dust bag has, the less frequently it will need to be changed.
As stated above in Professional Guidelines for Podiatric Nail Drills, the handpiece must be autoclaveable to reduce cross-infection between patients.
The size, weight and ergonomics of drill's handpiece should be taken into consideration. If it is too heavy it will cause aching of the podiatrists hand and arm. It should feel comfortable in the hand and be easy to grip.
A useful feature is an on/off switch on handpiece since this allows podiatrist to turn the drill off quickly.
Different mechanisms are available for changing the burr. It is best to have a mechanism that will allow the burr to be changed quickly and easily and which provides a firm grip on the burr.
Some dust extraction drills, such as those manufactured by Hadewe, have single point suction on the handpiece. Whilst other podiatry drills may have suction from several points all the way round the handpiece, i.e. round suction. This is illustrated in the photographs below which are from Hadewe's website http://www.hadewe.de/en. Neither type is better, the choice is down to personal preference, however, round suction handpieces are wider which may be a disadvantage if you have small hands.
Podiatry drill without any suction
Dust extraction drill with point suction
Dust extraction drill with round suction
General features that should be considered are the weight and size of the dust extraction unit, ease of use, the quality of the instruction manual, the amount of technical support from the seller and their after sales service.
As with any piece of mechanical equipment, dust extraction drills can break or malfunction. When considering a supplier it is worth finding out whether they have trained technical staff who can carry out repairs. And if so, do they keep spare parts for your machine in stock or will they have to wait to receive them from the manufacturer or even send the toe nail drill back to the manufacturer. Does the dust extraction drill come with a warranty?
Information for this article has been researched from on-line podiatry forums, dust extraction drill manufacturer and retailer websites and from the following medical research papers:
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please send an e-mail to footcare (a) podiatristclinic.co.uk
Podiatrist Clinic provides advice about <a href="http://www.podiatristclinic.co.uk/podiatry-equipment/dust-extraction-drill.html>podiatry dust extraction drills</a>.
|Manufacturer / Model||Dimensions (cm)||Weight (kg)||Power||Speed (rpm)||Suction (l/min)||Price Ex-VAT (£)|
|Hadewe SB12 Drill||25.4 x 14.4 x 18.4||3.5||240v / 550w||2,000 - 12,000||160||572.25|
|Hadewe SB22 Drill||25.4 x 14.4 x 18.4||3.4||240v / 550w||4,000 - 22,000||160||635.25|
|FiltAir Pure Drill||25.5 x 11.5 x 23||1.5||240v / 60w||2,000-20,000||150||695.00|
|Podotronic EVO 30||24.6 x 13.4 x 22.8||4.0||500 w||30,000||695.00|
|Podotronic EVO 50||24.6 x 13.4 x 22.8||4.0||500 w||40,000||895.00|
|Suda 650 Drill||11 x 14 x 26||2.8||240v / 220w||6,000 - 8,000||908.25|
|Berchtold S35 Drill||28 x 11 x 25||4.0||240 v||5,000-25,000||925.00|
|Suda 381 Drill||11 x 14 x 26||3.7||240v / 220w||3,500 - 12,000||955.50|
|Hadewe Chronos Light Drill||28.2 x 13.3 x 19.5||3.5||240v / 550w||7,000 - 40,000||960.75|
|Bentlon Podo Drill||27.5 x 23.0 x 14.0||3.6||220/240 v||6,000 - 40,000|
|Hadewe SB40 Drill||28.5 x 15.4 x 18.4||3.5||240v / 550w||4,000 - 40,000||160|
This table shows podiatry dust extraction drills and typical specifications. Information correct as of May 2009.