Effect of Phenol Application Time in the Treatment of Onychocryptosis: A Randomized Double-Blind Clinical Trial

Abstract

Background: In the treatment of Onychocryptosis, chemical matricectomy with 88% phenol solution is one of the most common surgical procedures due to a recurrence rate of less than 5%, but it may produce a delay in healing time. The objective was to compare the healing time between phenol applications of 30 or 60 s. Methods: A comparative, prospective, parallel, randomized, and blinded clinical trial was registered with the European Clinical Trials Database. Twenty-seven patients (54 feet) with 108 affected nail folds were randomized and treated with chemical matricectomy with phenol. Each hallux was randomly assigned to one of two groups (60 vs. 30 s phenolization). Each patient and one investigator were blinded to the phenol application time in each foot. The outcome measurements were healing time, recurrence, pain, post-surgical bleeding, inflammation, and infection rate. Results: The 30 s application presents a shorter healing time (14.93 ± 2.81 days vs. 22.07 ± 3.16 days; p < 0.001) with a similar recurrence rate (p = 0.99). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The 30 s phenol application time offers a shorter healing time than 60 s without affecting the effectiveness of the procedure, showing the same rate of complications.

A systematic review and meta‐analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms

“…One study compared chemical matrixectomy with phenol or trichloroacetic acid [27]. Four studies compared the same surgical intervention and introduced a chemical matrixectomy at different application timings [20, 22, 23, 51].…”

“…Attempts were made to obtain an update on progress from the listed investigators but with no success. Three trial registries of interest were also identified (NCT03732313; IRCT201604176403N6; ACTRN12619001719123), however results were already included in this review [40, 42, 51].…”

“…Of the one study [51] that was included in the meta-analysis, Muriel-Sanchez and colleagues compared the recurrence rate between phenol applications of 30 or 60 s, finding the 60-s application was more effective at preventing recurrence compared to the 30-s phenol application (RR 2.00 [95% CI 0.19 to 21.41]) (Supplementary Fig. 10).…”

“…Chemical application time: 30 vs 60 s Four studies used the same surgical intervention but varied the duration that the chemical was applied during the matrixectomy [20,22,23,51]. Of these, three studies [20,22,23] could not be included in the meta-analysis, and none reported significant differences in chemical timing applications.…”

A systematic review and meta‐analysis of randomised controlled trials of surgical treatments for ingrown toenails part II: healing time, post‐operative complications, pain, and participant satisfaction

“…Twenty studies [20,21,23,[25][26][27][32][33][34][35][36][37][38][39][40][41][42][43][44][45] (Table 3) assessed the post-operative complications of infection and/or haemorrhage. Follow-up times varied across the studies, ranging from just 48 h for haemorrhage [32], to 3 to 5 days for infection [45] and some up to 6 months [42] and beyond.…”