Treatment Of Ingrown Toenails Research Articles

Ingrown Toenails: A Survey Among Dermatologists on Current Treatments.

To date, there is no formal consensus on how to treat ingrown toenails. Despite the risk of causing irreparable damage to the nail, highly invasive procedures are still common. Less-invasive, matrix-directed techniques with shorter downtime and high cure rates exist, but, perhaps because of a lack of awareness, appear not to have been universally adopted. The authors' study sought to generate data on common practices in the treatment of ingrown toenails. The authors developed and conducted an online survey to ask dermatologists/dermatosurgeons how they would proceed in 9 different cases of ingrown toenails based on photographs. The authors received 154 replies. Nonsurgical interventions, including advice on nail care/foot baths/ointments/wraps/padding, were always the most frequently chosen option. Removal of the lateral nail plate followed by chemical partial matricectomy (phenolization) was the most or second-most frequently chosen surgical intervention. The answers were highly heterogeneous, and there was no unanimity based on morphology alone. Except for a preference for nonsurgical interventions, the authors could not identify any clear treatment standards. The heterogeneity of treatment approaches suggests the need for a guideline.

Anatomical Rationale for the Choice of Surgical Intervention for an Ingrown Nail

BACKGROUND. An ingrown toenail is one of the reasons for surgical intervention: it accounts for up to 20 % of all operations in clinics. At the same time, conservative and surgical approaches to treatment are not reliable enough: up to 70% of cases are complicated by relapses. AIM OF STUDY. To study the topographic location and ratio of cells in the growth zone of the nail plate, necessary for planning the volume of intervention in the treatment of ingrown toenails. MATERIAL AND METHODS. The material for conducting our own research was samples of the cadaver nail complex, without identified pathologies, from 20 objects of different ages and genders. Studies were carried out using histological, immunofluorescent and microscopic methods. The results were compared with available literature data, clarifying the most important structural features. The data obtained will make it possible to reasonably plan the volume of intervention during operations for ingrown nails, as well as to reduce the number of unsatisfactory results of operations on the nail complex in case of injury and nail diseases.

Treatment of Ingrown Toenail with a Minimally Invasive Nail Fixator: Comparative Study with Winograd Technique.

Many surgical techniques have been reported for treatment of ingrown toenails. Occurrence of infection after matricectomy procedures could cause clinicians to prefer using external braces in the treatment of ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique. Patients who underwent ingrown toenail surgery were reviewed retrospectively. The patients' demographic characteristics (ie, age, gender, body mass index morphology according to Heifetz classification, surgical technique, visual analogue scale values, time to return to daily activities [days], complications, and satisfaction levels) were all recorded. Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients' age, gender, body mass index, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and visual analogue scale values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique. Nail fixation can be an effective surgical treatment option for ingrown toenail.

Treatment of ingrown toe nail by homoeopathic approach

Treatment of ingrown toe nail by homoeopathic approach

Treatment of ingrown toenail with proximolateral matrix partial excision

Treatment of ingrown toenail with proximolateral matrix partial excision

Toenail Paronychium Flap: Novel Surgical Approach for Ingrowing Toenail and Review of the Literature of Conventional Surgical Methods

Ingrown toenails are most common among school-age children and adolescents though they can be observed at any age. Causes of ingrown toenails are increased curvature, trauma, and external pressure. Treatment of ingrown toenails can be broadly characterized as conservative and surgical. Conservative treatment can be performed using various methods, such as a gutter splint, dental floss, and cotton. Surgical treatments may be divided into two main approaches; narrowing of the nail plate and debulking of periungual tissues. However, these various conservative and surgical treatments have high recurrence rates, and thus, the author used a permanent surgical method based on the use of a paronychium flap to treat a 15-year-old male adolescent with excessive periungual tissues and curved ingrown toenails who did not improve despite conservative and several surgical treatments over 4 years. Subsequently, toenail shape was maintained without recurrence 22 months after surgery, and there were no complaints of inflammation or pain while walking. This simple surgical method can be performed on patients with advanced ingrown toenails due to excessive periungual tissues and nail curvature and can be expected to have permanent effects.

The effectiveness of matrix ablation with silver nitrate in the treatment of ingrown toenails. A single-center case-control study.

Partial onychectomy with chemical matrixectomy is considered the gold standard treatment for stage II-III ingrown toenails (IT). However, there are scarce reports describing the use of silver nitrate in IT management in adolescents. Our aim is to analyze the effectiveness of matrix ablation with silver nitrate and compare it with partial onychectomy by electrocautery. A retrospective study of adolescent patients with stage II-III IT was performed. Those who underwent electrocautery matricectomy in a major outpatient surgical center (Group A) and those who were treated with silver nitrate at an outpatient clinic (Group B) were compared. Efficacy was determined by recurrence and postoperative infection rates. Two hundred and nine patients were included (86 group A; 123 group B), with a total of 382 partial onychectomies (151 group A; 231 group B). Group B patients exhibited a lower recurrence rate (4.7%) when compared to group A (11.2%, p= .02), and had a lower postoperative infection rate (4.0% group A vs. 1.7% group B; p= .18), although not statistically significant. Silver nitrate chemical matricectomy after partial onychectomy is an effective treatment for IT in adolescents, with few postoperative complications and low recurrence rate. Therefore, it should be considered as a possible alternative to electrocautery matricectomy.

Is the Winograd Technique an Effective Method in the Treatment of Ingrown Toenails among the Pediatric Population?

Is the Winograd Technique an Effective Method in the Treatment of Ingrown Toenails among the Pediatric Population?

Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails.

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

Spiculectomy and Orthonyxia for Ingrown Toenails in Patients at Risk; Prospective Observational Cohort Study

Background: Ingrown toenails (unguis incarnatus) are common in persons with Diabetes Mellitus (DM) and Peripheral Arterial Disease (PAD). Minimal invasive treatment of ingrown toenails with spiculectomy and/or orthonyxia might be a promising treatment option. Aim: The aim of this study was to evaluate the efficacy and safety of minimal invasive treatment spiculectomy and orthonyxia Design/Setting: Prospective observational cohort study in an outpatient podiatric clinic Method: Eighty-eight patients with unguis incarnatus were included. Primary outcomes were post-procedural complication rate (infection and hemorrhage), and duration of pain. Patient satisfaction during and after treatment procedure was evaluated. Results: Healing was achieved in 80/88 (90.9%) persons; non-DM group 28/32 (87.5%) vs DM group 51/56 (91.1%); median healing time (21 [14, 42] days) and median treatment time; (56 [30, 86] days) were comparable between the non-DM and the DM groups. (Sixty-four patients (72.7%) had a significant pain reduction within 0-2 days. Median reduction of the VAS score after the first treatment was 2.0 points [0.0, 6.0] (non-DM group 3.5[1.0, 6.0]; DM group 2.0[0.0, 5.0] (p=0.0117)). Forty-eight (94, 4%) patients, 31(96.9%) non-DM group vs 53(94.6%) DM group (p=0.534)) had no limitations in daily activities by the affected toe after 14 days. There were no treatment-related complications like bleeding or infection. Conclusion: Spiculectomy and orthonyxia resulted in a high patient satisfaction. Five of 88 patients needed referral for a partial nail resection. This treatment seems to be very suiTable for persons with a high risk for foot ulcerations.

What is the best treatment for ingrown toenails?

What is the best treatment for ingrown toenails?

Portable Diode Laser Scalpel in Treatment of Ingrown Toenails in Children

Introduction.The ingrown nail (onychocryptosis) is a disease that is common both among children and in adult population. Despite the fact that there is a large number of methods available for the treatment of ingrown nails, a large percentage of recurrence of the disease remains unconquered. Traditional methods of treatment today are often complemented by chemical matrixectomy, cryodestruction, electrocoagulation or laser destruction of the growth zone of the nail plate piece being removed. The purpose of all of these methods of treatment is the reduction of the recurrence of the disease. This study aims to examine the possibilities of using a portable diode laser scalpel for the treatment of ingrown nails in children.Materials and methods.In this study the authors compared treatment outcomes in patients with ingrown toenails treated with the original Winograd procedure (30 patients) with those treated with the same procedure complemented by the laser destruction of the growth zone (50 patients).Results and discussion.There was one relapse case in the study group (n=50, 2%), and two — in the control group (n=30, 6.7 %). The healing period of the postoperative wound amounted to 17.3±2.05 days in the study group and to 12.25±1.24 days in control. Pain VAS scores on the first day following the surgery were 6.2±1.24 in the study group, and 5.8±0.816 in control. Staphylococcus aureus was the pathogen responsible for the local infection process in most patients with ingrown nails.Conclusion. This study demonstrates that using the method proposed results in the reduction of the risk of recurrence of the disease from 6.7% down to 2%, increasing, however, the healing time of the postoperative wound from 12.25±1.24 to 17.3±2.05 days. This makes the use of the method proposed advisable in patients with: a stage III ingrown nail; an apparent local infectious process; a recurrent ingrown nail.

A Survey Study on Causes, Treatment and Prevention of Onychocryptosis

Introduction: An ingrown toenail, also called as onychocryptosis, is one of the most common disorders of the toe. It is described as the extension of the side of the nail inside the nail bed which causes bleeding, sharp pain and possible infection can occur. The main causes of this condition are any injury to the nail, bacterial infection of the nail bed or wearing tight fitting shoes on a daily basis. The aim of this research is to check the status of ingrown toenails in an area. Materials and Method: 26 people ranging from the age 12 to 60 who have had ingrown toenail in the past or had ingrown toenail during the time of data collection were included. Their preferred type of footwear, occupation, treatment taken, places visited often before the condition developed were recorded and the cause of their disorder was deduced. Based on these data, the methods to prevent ingrown toenails were deduced. Result: Teenagers are more prone to ingrown toenails than any other age groups. Stage 1 was the most common type of ingrown toenail. Out of the people who had ingrown toenails, most of them wore poorly fitting shoes. Trauma to the nail was the most common cause of ingrown toenail. Conservative Therapy was the most common type of treatment for ingrown toenails. Conclusion: Ingrown toenail is one of the most common nail disorders. Since teenagers are the most agile group, they are more prone to the disease. This disease can be easily avoided by maintaining the hygiene of the feet and by wearing proper fitting shoes.

The Treatment of Ingrown Toenails: A Retrospective Study of Combined Wedge Resection with Phenol Versus Silver Nitrate Cauterization

The Treatment of Ingrown Toenails: A Retrospective Study of Combined Wedge Resection with Phenol Versus Silver Nitrate Cauterization

Improved outcomes of a modified suture technique applied after nail fold and partial nail bed excision

Objective To evaluate the effect of the modified suture technique applied after nail fold and partial nail bed excision for the treatment of ingrown toenails. Methods From July 2014 to December 2016, 96 cases of ingrown toenails were performed with nail fold and partial nail bed excision. The modified suture technique was used in 46 cases (study group) and the traditional suture technique was used in 50 cases (control group). Postoperative pain, bleeding, infection, recurrence, the recovery time of normal walking and wound healing time were observed and compared. Results After operation, 91 patients were follow-up for 9 to 16 months with an average of 12. 3 months, while 5 cases were lost. The level of postoperative pain, bleeding, recovery time of normal walking and wound healing time from the study group were lower than those from the control group, and the differences were statistically significant (P 0. 05). Conclusion The improved suture technique can improve the postoperative pain and bleeding for the patients performed with nail fold and partial nail bed excision, shorten the recovery time of normal walking and the wound healing time, but it will not increase the rate of postoperative infection and recurrence. Key words: Nails, ingrown; Surgical procedures, operative; Suture techniques

NAIL-FOLD EXCISION WITHOUT MATRICECTOMY FOR TREATMENT OF INGROWN TOE NAILS

Background: Ingrown toe nails are a painful condition occurs when one of the distal sides of nail plates causes pressure or actually punctures the periungual skin. A wide variety of treatment modalities are existed in the literature. Objectives: Evaluation of the technique of lateral nail-fold excision without matricectomy in treatment of ingrown toenails. Patients and Methods: The study was a prospective observational study carried on 83 patients; 57 males (68.7%) and 26 females (31.3%) with a mean age of 21.3±4.2 (range 13–41) years who presented with ingrown toe nails. All patients underwent lateral nail fold excision technique as a treatment of ingrown toe nails. Results: Recurrence rate was 3.6%, postoperative erythema and swelling was 3.6%, and inflammatory exudate was 4.8%. Significant loss of sensation around the area of surgery was 2.4%, and 94% of patients were strongly satisfied with the procedure. Conclusion: This technique was effective in treatment of ingrown toe nails with a low rate of recurrence, less pain, good cosmetic results, and high satisfaction rates.

The Effectiveness of Matrix Cauterization With Bichloracetic Acid in the Treatment of Ingrown Toenails: ERRATUM.

The Effectiveness of Matrix Cauterization With Bichloracetic Acid in the Treatment of Ingrown Toenails: ERRATUM.

Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails

An important component of the Winograd surgical method for an ingrown toenail is total excision of the associated germinal matrix. However, this might not always be accomplished with the procedure. We hypothesized that the surgical results might be improved by adding electrocoagulation of the germinal matrix to the Winograd method. The objective of the present study was to compare the recurrence, satisfaction, and complication rates of the Winograd method with those of the Winograd method with electrocoagulation. We retrospectively evaluated the records of 102 patients with single Heifetz stage 2 or 3 ingrown toenails who had undergone surgery from January 2013 to October 2014 using 1 of these 2 methods. Of the 102 patients, 50 (49%) underwent the Winograd method and 52 (51%) underwent the Winograd method with electrocoagulation. The mean follow-up period of our patients was 12 (range 6 to 22) months. An ingrown toenail recurred in 3 patients (6%) in the Winograd group and in no patient in the Winograd with electrocoagulation group (p = .04). Among the patients in the Winograd group, 46 (92.0%) were satisfied or very satisfied. Among the patients in the Winograd plus electrocoagulation group, 49 (94.2%) were satisfied or very satisfied (p = .04). No complications developed in either group. In conclusion, the Winograd method for ingrown toenails results in high satisfaction rates, low recurrence rates, and low complication rates. The addition of electrocoagulation of the germinal matrix to the Winograd method could result in even lower recurrence rates, while maintaining high patient satisfaction and without increasing the risk of complications.

Treatment of ingrown toe nail by using Tsume-Cap and its usefulness

Treatment of ingrown toe nail by using Tsume-Cap and its usefulness

Partial Matricectomy with Cryotherapy in Treatment of Ingrown Toenails

Partial Matricectomy with Cryotherapy in Treatment of Ingrown Toenails