Soft-Tissue Nail Fold Arc Resection Combined with a Shaped Dressing for Ingrown Toenails.

Abstract

The objective of this study was to evaluate the effectiveness of the surgical method of arc resection of soft-tissue nail fold combined with a shaped dressing for ingrown toenails. The surgical method involved the excision of nail fold granulation tissue and partial or total nail avulsion with preservation of its matrix. This surgical approach was applied to 20 consecutive patients (age range, 11-30 years) admitted to the hospital from January 1, 2014, to December 31, 2015. For assessment of the method, the operative technique, dressing change, and postoperative wound healing were recorded by photography. Finally, we evaluated the therapeutic effects by calculating the recurrence rate and nail groove expansion rate. Twenty patients with 38 surgical sites in 26 toes were analyzed; there was no recurrence at 3, 6, and 12 months. There was a statistically significant difference in the groove expansion rate at different time points. We measured the wound distance on postoperative day 1 compared with the day of healing and found that the method of shaped dressing could expand the nail groove by more than 50% (P ≤ .05). The mean ± SD recovery time was 15.1 ± 2.4 days. Arc resection of the nail folds for ingrown toenails coupled with preservation of its matrix minimizes trauma and is easy to manipulate. Applying a shaped dressing after the operation further reduces the risk of recurrence and ensures enough growth space for the toenails.