Wedge resection alone or combined with segmental phenolization for the treatment of ingrowing toenail

Department of Surgery, Meath Hospital, Dublin, Ireland.
British Journal of Surgery (Impact Factor: 5.54). 07/1994; 81(7):1074-5. DOI: 10.1002/bjs.1800810751
Source: PubMed

ABSTRACT A retrospective analysis was undertaken of 387 patients treated surgically for ingrowing toenail between 1987 and 1989. In all, 203 patients were assessed and had 309 procedures performed on the median and/or lateral margins of one or both halluces. The procedures were performed by all grades of surgeon. A total of 126 wedge resections and 183 wedge resection-segmental phenolization combination treatments were performed. There were significantly fewer recurrences in the group receiving combination treatment (eight; 4.4 per cent) than in that having wedge resection alone (22; 17.5 per cent) (P < 0.001). Patients having procedures performed by senior house officers had a significantly greater chance of recurrence if a wedge resection alone was performed. It is concluded that the combination procedure gives better long-term results than wedge resection alone and can be used successfully by all grades of surgeon.

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    • "Since then, phenol has emerged as the treatment of choice for this condition in adults [4]. Multiple studies have documented a lower recurrence rate, a better cosmetic appearance, less pain, and earlier resumption of work or normal activities with this type of treatment as compared with a surgical excision of the matrix [5] [6] [7] [8] [9] [12]. Phenol, originally called carbolic acid, was used by Lister for sterilization of the operating field until its toxic nature to the tissues was noted. "
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    ABSTRACT: Ingrown toenails in children are a common problem with a high recurrence rate. The objective of this retrospective data review was to compare simple excision of the nail matrix with excision plus phenol (EPP) application in the treatment of ingrown toenails. The charts of 69 children who underwent surgical treatment of one or more ingrown toenails from 1994 to 2000 were reviewed. The primary procedure was noted (excision alone [EA] vs EPP) and dates of recurrences and reoperations were recorded. Parents were then surveyed by phone regarding complications, cosmetic outcome, and overall satisfaction with the procedure. Five scale categories, ranging from "strongly agree" to "strongly disagree", were used, with responses of "strongly agree" and "agree" considered as a good outcome. Either Student's t test or the chi2 test (P < .05 considered significant) was used for analysis. Thirty-one patients (45%) were in the EPP group whereas the remaining 38 had EA. Mean length of follow-up was 4.3 years for the EA group and 2.1 years for the EPP group. There was no difference in age at operation or length of follow-up between the 2 groups. Boys were predominant in both groups. The survey response rate was 50/69 (73%). The recurrence rate of ingrown toenails in the EA group was 42% vs 4% in the EPP group (P = .003). There were no significant differences in parental response with regard to operative experience (P = .31) and the cosmetic result (P = .13), with most of the respondents (78%) indicating a good outcome for both questions. The addition of phenol to the surgical excision of ingrown toenail significantly reduced the incidence of recurrence, with similar patient satisfaction and an equivalent cosmetic result.
    Journal of Pediatric Surgery 01/2005; 40(1):290-2. DOI:10.1016/j.jpedsurg.2004.09.051 · 1.39 Impact Factor
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    ABSTRACT: There are many options for the treatment of ingrowing toenail, ranging from simple conservative approaches to extensive surgical procedures. Although conservative treatment modalities are helpful in patients with stage 1 disease, stage 2 and 3 ingrowing toenails are best treated surgically. The aim of this study was to evaluate the efficacy of chemical matricectomy with phenol for the treatment of ingrowing toenail. A total of 350 phenol ablations were performed on 172 patients with stage 2 and 3 disease. Each patient was reviewed weekly until full wound healing was achieved and afterwards, to assess the long-term efficacy of the treatment, they were followed up for a mean period of 25 months. The healing period after the operation ranged from 2 to 4 weeks and no postoperative complications were seen. Only two recurrences (0.57%) were observed, after 9 and 17 months, respectively, and nail spikes had developed in only two toes (0.57%). The success rate was found to be 98.8%. We conclude that phenol cauterization is an excellent surgical method for the treatment of ingrowing toenail because of its simplicity, low morbidity and high success rate.
    Acta Dermato Venereologica 01/2001; 81(3):181-3. DOI:10.1080/000155501750376267 · 3.03 Impact Factor
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    ABSTRACT: Objectives: Ingrown toenail is a frequent problem which can be seen in all ages. There are many treatment meth-ods both surgical and nonsurgical. In this study we evalu-ated the results of wedge resection of ingrown toe nail.
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