Gutter treatment for ingrowing toenails.

Abstract

Summary and conclusionsThe gutter treatment for ingrowing toenails consists of introducing a small guard along the side of the toenail and requires only three outpatient attendances. The gutter is left in place for eight to 12 weeks and then removed by the patient. Two studies were carried out to establish the long-term results of the method. In one, a preliminary retrospective study, 13 out of 25 patients who had received the gutter treatment were cured after one year compared with five out of 15 patients in whom the toenail had been avulsed. In a randomised prospective study 20 out of 36 patients (56%) treated by the gutter method were cured after one year compared with 27 out of 32 (84%) in whom the wedge resection procedure had been used.The gutter treatment demands little skill and may be carried out in general practice. It gives an excellent cosmetic result with immediate pain relief and does not compromise further surgery should this be required, thus fulfilling the main requirements for the primary treatment of choice.

Wedge Excision of the Nail Fold in the Treatment of Ingrown Toenail

“…This procedure is valid only in stage 1 disease and requires patient cooperation. 10,11 Surgical techniques can address the nail, fold, or both. Removal of the nail encompasses ablative and nonablative procedures; ablative techniques imply the total or partial destruction of the germinal matrix, whereas nonablative modalities preserve it.…”

“…[5][6][7][8][9][10] Patients must keep the device until the nail grows over the nail fold. This procedure is valid only in stage 1 disease and requires patient cooperation.…”

The Treatment Role of the Plastic Nail Guard for Ingrowing Toenails

“…Other devices followed, but all relied on the same basic principle of nail sulcus protection (6,7,8). Wallace designed and commercially produced his own 'nail gutter' device, but this is no longer available.…”

Ingrown toenails

“…The plastic tube is then attached with either adhesive tape, cyanoacrylate adhesive or wound closure strips [ Figure 3]. [24][25][26][27] After splinting, patients experience instant relief of pain. They are instructed to wash the toe once daily with, povidone-iodine for up to 3 or 4 weeks.…”