A new modification of the Winograd technique for the treatment of ingrown toenail

Abstract

Introduction: Ingrown toenails are one of the most common nail pathologies, being the main reason for consultations for nail pain. The Winograd technique, commonly known as wedge excision, is one of the most used techniques due to the low rate of recurrences and overall patient satisfaction. We consider it possible to mitigate some possible disadvantages, reducing the already low risk of infection, as well as the risk of onycholysis, by modifying the incisional approach and using only adhesive approximation strips. The objective of this work is to proves the effectiveness of the modification of the original Winograd technique for the treatment of ingrown toenail. Patients and methods: A retrospective study, with a sample of 111 patients and 159 digits were operated on between 2003 and 2019 in clinics in Vila Nova de Famalicão, Viana do Castelo and Lisboa (Portugal), with a follow-up period of more than 15 years. Data on: a) postoperative complications, b) the time elapsed to wound healing, c) the rate of recurrences, and d) general patient satisfaction were collected.Results: The results revealed 1.8 % of heavy bleeding, 3.6 % of postoperative complications, 2.70 % of recurrences and 8.10 ± 0.76 of wound healing days. Patients reported very low postoperative pain (0.9 %) and high satisfaction results (99.1 % for the functional result; 94.6 % for the aesthetic result and 97.3% for patient satisfaction).Conclusions: The modifications performed have better results than those reported with the conventional technique, in terms of recurrence, average period of time from surgery to wound healing and return to daily activities and general patient satisfaction, suggesting its safe current use in clinical practice for the treatment of grades II and III ingrown toenail. ResumenIntroducción: Las uñas encarnadas son una de las patologías ungueales más frecuentes y puede utilizarse la técnica de Winograd, entre otras, para su tratamiento quirúrgico. Propusimos reducir el riesgo de infección, onicolisis y tiempo de cicatrización, modificando el abordaje incisional y utilizando tiras adhesivas de aproximación.