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: 5.21). 08/1994; 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.

  • Source
    [Show abstract] [Hide abstract]
    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.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ingrown (or ingrowing) toenail is a commonly used term for onychocryptosis, in which the nail becomes inserted into the lateral fold of the toe. The resulting effect on a person's health, well-being, and ability to work suggests the importance of clear treatment guidance, but little consensus exists. To explore postoperative recovery after surgery for ingrown toenails using chemical (sodium hydroxide (NaOH)) or mechanical (wedge resection) matricectomy and thus contribute to understanding within the field on which to base treatment guidelines. One hundred sixty-one procedures were undertaken, 94 using NaOH and 67 using wedge resection. Four measures of postoperative recovery were recorded: recurrence, infection, time to discharge, and number of postoperative visits. Patients treated with NaOH had lower rates of recurrence (p = .048) and infection (p = .03) than those treated with wedge resection, and time to discharge was shorter (p = .02), but they had more postoperative visits (p = .003). Low rates of recurrence and infection and short postoperative recovery time were found after both procedures, with a small advantage with treatment with NaOH. The authors argue for the value of clinical intervention using matricectomy in early stages to avoid complications resulting from granulation tissue growth.
    Dermatologic Surgery 01/2014; · 1.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Phenolization is often used to treat ingrown toenails. Alcohol lavage with or without supplemental chlorhexidine may be used to remove residual phenol, which can contribute to side effects such as persistent oozing or drainage. We sought to compare the effectiveness in removing residual phenol of lavage with alcohol plus chlorhexidine versus alcohol alone. We studied 80 patients who underwent unilateral phenol matricectomy: 40 who received irrigation with alcohol alone and 40 who received irrigation with alcohol plus chlorhexidine. Phenol levels were measured after each of 5 rounds of 3-mL irrigations. After the first irrigation, an average of 44.92% and 38.35% of the phenol remained in the nailfold in the alcohol and the alcohol/chlorhexidine groups, respectively (P < .05). After all 5 irrigations, no difference in efficacy between the 2 solutions was found (P > .005). It was not possible to calculate the quantity of phenol initially introduced into the nail bed. The percentage remaining was calculated from the total amount of phenol recovered. When a single irrigation step is performed after phenolization, alcohol plus chlorhexidine is more effective than alcohol alone for removing residual phenol. When multiple irrigations are performed, the 2 solutions are equally effective.
    Journal of the American Academy of Dermatology 03/2014; · 5.00 Impact Factor