The surgical treatment of ingrowing toenails

Abstract

Two prospective studies of ingrowing toenail management were conducted. In the first, 163 patients (204 ingrowing nail edges) who had not had previous surgery were randomised and treated by total nail avulsion, nail edge excision, or nail edge excision with phenolisation of the germinal matrix; recurrence rates one year postoperatively were 73%, 73% and 9% respectively. In the second study, 63 ingrowing nail edges which had recurred after previous operations underwent nail edge excision and phenolisation. There was a 5% recurrence rate and 5% incidence of dystrophy of the nail one year after operation.

Surgical treatment of ingrown toenails in children: what is best practice?

“…2 IGTNs frequently require multiple procedures, a finding that is demonstrated in several other papers. 2,11,12 Within our centre currently, the most common operation performed for the recurrence of an IGTN is a wedge excision with the addition of phenol, accounting for 44.8% of second-line procedures. Other studies have shown that plain avulsions or avulsion with chemical matrixectomy are the most popular choices as the management of recurrent IGTNs.…”

“…2 Several previous studies have demonstrated that the addition of phenol significantly reduces the recurrence rate of IGTN within individual surgical techniques. 1,[8][9][10][11] A Cochrane review of IGTN surgery in adults found that avulsion with the use of phenol was more effective at reducing symptomatic recurrence than nail bed excision techniques. 1 Conversely, a recent study in 2007 showed that phenol used with wedge excisions significantly increases recurrence rates within the paediatric population.…”

“…8 Since then, several studies have demonstrated its effectiveness when used alone or in combination with a surgical procedure for the treatment of IGTNs. 1,[8][9][10][11] In our own centre, the application of phenol is standardised as careful local administration for 2 min using either soaked cotton wool or an applicator stick.…”

Treatment of Ingrown Toenail With Proximolateral Matrix Partial Excision and Matrix Phenolization

“…Conventional surgical treatment of ingrown toenails has been associated with an unacceptably high recurrence rate, substantial postoperative pain, and poor cosmetic results. 10,11 Simple nail edge excision has a recurrence rate of 39%, 10,12 and total nail avulsion has a recurrence rate of 83%, 13,14 whereas soft tissue resection has a cure rate of 60%. 10,14,15 The reported recurrence rate after wedge resection ranges from 12% to 30%.…”

Medical Treatment of Ingrown Toenails by Chemical Matricectomy Using Phenol

“…Unacceptably high recurrence rates, poor cosmetic results, and significant postoperative pain have been associated with conventional surgical treatments [7,8]. Published studies indicate that total nail avulsion is associated with a recurrence rate of 83% and simple nail edge removal has a recurrence rate of 39%, while soft tissue resection may cure as many as 60% of cases [7,8,9,10,11]. A 12-30% rate of recurrence has been reported following wedge resection [8,12,13].…”