Winograd Technique Research Articles

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.

A novel modified Winograd surgical tricks and tips with a “bird flap” for the treatment of ingrown toenails

BackgroundThe Winograd technique is the most commonly used surgical treatment for ingrown toenails. We describe a novel modified approach, more effective and simpler to perform with a better cosmetic outcome. MethodsWe retrospectively included 45 and 39 patients with 67 and 58 ingrown toenails who underwent our modified Winograd technique and the Winograd technique, respectively, from July 2017 to June 2020, and obtained data after 3, 6, and 12 months of follow-up. ResultsNo significant differences in the postoperative time taken to return to regular activities in the modified Winograd and traditional Winograd groups (p = 0.103) and regarding the recurrence in both groups (p = 0.055) were found. The extent of proximal germinal matrix exposure with the modified Winograd technique was significantly more clearly revealed than in the traditional Winograd method contextually (p < 0.05). The postoperative appearance satisfaction rate was significantly higher in the modified Winograd group than in the traditional Winograd group (p = 0.029). ConclusionThe modified Winograd technique is effective in treating ingrown toenails.

Batık Tırnak Tedavisinde Winograde Ve Vandenbos Cerrahi Tekniklerinin Heifetz Evresine Göre Karşılaştırılması

Abstract&#x0D; Background: In ingrown toenail, classifications and the treatment approaches according to staging has been clearly reported in the literature. However, there are not enough data about the selection of the appropriate surgical technique according to the stage. In this study, we compared two different surgical techniques in patients with Heifetz stage 2 and 3 in means of surgical results, recovery time, patient comfort and cosmetics.&#x0D; Methods: Between January 2019 and January 21, patients who applied with the complaint of ingrown toenails who were treated with two mentioned surgical techniques in two centers with at least 1 year follow-up were included. The patients were evaluated preoperatively in means of the Heifetz classification. In group 1 (n:54) matrix excising Winograd and in group 2 (n:51) matrix preserving Vandenbos techniques were used. Postoperative recovery time, complication rates, functional and cosmetic patient satisfaction were evaluated in tall cases. &#x0D; Results: 105 cases of ingrown toenails treated surgically were included in the study. 62 (59%) cases were Heifetz stage 2, 43 (41%) cases were Heifetz stage 3. No statistically significant difference was found between Heifetz stage 2 and stage 3, regardless of surgical technique, in complication, recurrence, patient functional/cosmetic satisfaction rates, and recovery time. In overall analysis regardless of Heifetz staging, recovery time was shorter with Winograd method (p:0.0001), complication and recurrence rates were lower with Vandenbos method (p:0.0001), and VAS cosmetic satisfaction was higher in Vandenbos (p:0.002).&#x0D; Conclusion: Winograd and Vandenbos in Heifitz stages 2 and 3 have low complication rates and high patient satisfaction. Earlier healing could be achieved with the Winograd technique, while low complication/recurrence rates and high cosmetic satisfaction could be achieved with the Vandenbos technique. Early recovery/high cosmetic expectation should be considered instead of Heifetz staging in determining the surgical technique.

The Modified versus the Conventional Winograd Technique for the Treatment of Onychocryptosis: A Retrospective Study.

The Winograd technique is a common surgical treatment for ingrown toenails. Attempting to improve the results of this technique, two modifications were adopted: the incisional approach and the use of adhesive approximation strips. This study aimed to compare the conventional technique and the modified version based on (i) postoperative complications, (ii) healing time, (iii) recurrence rate, and (iv) overall patient satisfaction. A longitudinal, observational, and retrospective design was used, with a sample of 208 patients divided into the modified Winograd technique (n = 111) and the conventional Winograd technique (n = 97) in three clinics in Portugal, with follow-up periods of more than 15 years and 10 years, respectively. The modifications to the Winograd technique revealed fewer postsurgical complications, in terms of infections (1.8% vs. 20.62%, p < 0.010), recurrence rate (2.7% vs. 5.21%, p > 0.05), shorter recovery time (8.10 ± 0.76 vs. 14.51 ± 3.48 days, p < 0.001), and lower postoperative pain and better satisfaction with the functional and esthetic results, with the patient’s overall satisfaction, and with significant differences in relation to the conventional technique (p < 0.001). The modifications performed showed a lower rate of infection, decreased healing time, and better patient satisfaction, suggesting that it may be adopted in clinical practice for the treatment of stages II and III ingrown toenails.

A new modification of the Winograd technique for the treatment of ingrown toenail

A new modification of the Winograd technique for the treatment of ingrown toenail

Does the Type of Surgical Technique and the Use of Prophylactic Antibiotics Affect the Clinical Results in Symptomatic Ingrown Toenail Patients?

Ingrown toenails are a common reason for referral to orthopedics and podiatry clinics. Recurrence and infection are common complications in ingrown toenail surgery. This study investigates the effect of an electrocautery matrixectomy on the recurrence and clinical outcomes in the Winograd technique applied in ingrown toenail surgery and whether prophylactic antibiotic use is necessary for these surgeries. One hundred forty-three patients who underwent surgery for ingrown toenails were analyzed retrospectively. Eighty-two patients underwent the Winograd procedure with electrocautery matrixectomy, whereas 61 patients underwent the Winograd procedure. While 78 patients were given prophylactic antibiotics, 65 patients were not. Patient satisfaction was evaluated with a surgical satisfaction questionnaire (SSQ). A visual analog score was used to evaluate the pain. Recurrence was observed in 3 toenails in the Winograd and electrocautery groups, while recurrence was observed in 9 toenails in the Winograd group (P = .018). In both groups, there was no statistically significant difference between the infection rates between patients who took antibiotics and those who did not (P > .05). There was no statistically significant difference between the groups in terms of SSQ scores (P > .05). It was observed that the surgery performed had a positive effect on pain, and this effect was statistically highly significant in both groups (P < .05). The outcomes of the present study suggest that the addition of an electrocautery matrixectomy to the Winograd technique in the surgical treatment of symptomatic Ingrown toenails may decrease recurrence rates. Additionally, this study showed that oral antibiotics, when used in addition to Ingrown toenail surgery, do not reduce postoperative morbidity.

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?

Results of Winograd technique (wedge resection of the toenail and nail bed) in ingrown toe nail

Background: Ingrown toe nail is a very common condition affecting toes which causes significant morbidity. Most common reasons are improper nail trimming or a tight show wear. Early stages can be managed conservatively by warm soaks, antibiotics and analgesics, however late stages need surgical intervention. Numerous surgical techniques have been described for this condition.Methods: A prospective study was carried out in District hospital Doda from November 2015 to November 2017. Wedge resection of the toe nail and nail bed (Winograd technique) was used. Recurrence rates, complications and patient satisfaction was noted at the end of follow up at one year.Results: We operated 29 toes in 23 patients. We had 3 (10.34%) recurrences out of 29 toes operated, 2 (6.89%) patients got secondarily infected. The overall satisfaction rate in our series was 69.56%.Conclusions: Winograd technique is an easy and safe procedure, however chances of recurrence and cosmetic disfigurement should be explained to the patient during consent.

The Clinical Results of the Modified Winograd Technique in the Treatment of Ingrown Nails

The Clinical Results of the Modified Winograd Technique in the Treatment of Ingrown Nails

Operative Treatment of the Ingrown Toenail With a Less-Invasive Technique: Flashback to the Original Winograd Technique.

The aim of this study was to evaluate the results of the partial nail plate excision and curettage of nail bed and matrix (the original Winograd technique) in patients with ingrown toenail. Patients with ingrown toenail who were treated surgically from May 2014 to June 2015, with a minimum follow-up of 1 year were included in this study. Those who had previous ingrown toenail surgery were excluded. Partial nail plate excision with curettage of nail bed and nail matrix was performed for all patients. Rifampicin soaked sterile gauze was placed onto the wounds after the procedure. The study population included 100 males and 89 females with a mean age of 30 years. Eight patients (4.2%) had stage 1, 71 patients (37.6%) had stage 2, and 110 patients (58.2%) had stage 3 ingrown toenails. The mean operation time was 4.8 minutes. No complication occurred during the procedure. It was found that 15 patients (7.9%) had recurrence during the follow-up. The original Winograd technique is an efficient and less-invasive technique for the treatment of ingrown toenail, with lower rates of recurrence and complications. Therapeutic Case Series Study, Level IV.

Nail Braces as an Alternative Treatment for Ingrown Toenails: Results From a Comparison With the Winograd Technique

Ingrown toenails are one of the most frequent nail disorders and can be treated with conservative or surgical approaches. Although discovered a long time ago, the available data are still very limited on the potential effectiveness of nail braces for ingrown toenail treatment. In the present retrospective study, we compared nail braces with surgical wedge excision using the Winograd technique with respect to the time to return to work, recurrence, interval to recurrence, and patient satisfaction. A total of 159 patients were divided into the nail brace (n = 74; mean age 29.51 ± 8.48 years) and Winograd technique (n = 85; mean age 26.95 ± 8.06 years) groups. In the nail brace group, the mean time to return to work (4.15 ± 1.07 days) was significantly shorter than that in the Winograd technique group (13.8 ± 2.26 days; p < .001). Patient satisfaction was significantly greater in the nail brace group (94.6%) compared with the Winograd technique group (82.4%; p = .018). Of the 159 patients, 6 (8.1%) in the nail brace group and 8 (9.4%) in the Winograd technique group developed recurrence; however, this difference was not statistically significant (p > .05). A statistically significant difference was observed in the mean interval to recurrence (12.46 ± 1.60 versus 13.24 ± 2.48 months, respectively; p = .031). The progression-free follow-up periods for the nail brace and Winograd technique groups were 15.45 ± 0.22 months (95% confidence interval 15.02 to 15.88) and 17.18 ± 0.29 months (95% confidence interval 16.61 to 17.84), respectively. We have concluded that the use of nail braces is an appropriate alternative treatment of ingrown toenails with high patient satisfaction, fast recovery times, and a low recurrence rate.

The preliminary outcome of syndactyly management in children with a new external separation device.

To introduce a new external fixation device for the management of syndactyly in children. To evaluate its preliminary clinical result. From January 2011 to June 2012, 12 cases with cutaneous syndactyly of the middle/ring finger were managed with a new external fixator designed by our department. There were eight cases on the right side and four on the left side. The web space and soft tissue were stretched gradually using the new device. A Z-plasty of syndactylies was performed when the web space has reached the width that we required. The results were evaluated according to the clinical appearance and function of the fingers. Twelve cases had been followed up, with an average time of 16 months (range, 12-27 months). The web space and soft tissue in all the cases were stretched successfully using the new device. Skin grafting was not necessary in the reconstruction of syndactyly. In the last follow-up, the Vancouver Score averaged 0.6 (range, 0-2). Three cases had grade 1 web creep, whereas the other nine cases had grade 0 web creep. The total active motion averaged 130.4° for all affected fingers: 130.8° for the middle and 130.0° for the ring finger. Stiffness in the PIP joint preoperatively in two cases did not improve postoperatively. In 12 affected middle fingers, three cases had a supination deformity averaging 10.6° (range, 5°-15°) and one case had a pronation deformity of 5°. In 12 affected ring fingers, one case had a supination deformity of 18° and two cases had a pronation deformity averaging 7.5° (range, 5°-10°). The middle finger was not pronated in any patient. Among all the ring fingers, two had radial deviation of 8°and 25° and 1 had ulnar deviation of 10°. The surgeon-provided visual analog scale score for esthetics averaged 1.8 (range, 0-5). The parent-provided visual analog scale score was 2.7 (range, 1-5) for pain, 1.3 (range, 0-5) for appearance, and 1.3 (range, 0-5) for function. Displacement of the nail bed during distraction was found in two cases, which was resolved by the Winograd technique in the second surgery of syndactyly release. The clinical appearance and function were excellent. When we use the new external fixation device in the management of syndactyly, we can achieve a satisfactory outcome with little scar of the fingers. There was no need for skin grafting. However, the long-term result should be studied further.

A New and Simple Suture Technique After Ingrown Toenail Surgery

Ingrown toenails are frequently encountered in clinical orthopedic practice. It mostly occurs in young people; therefore, it may cause a huge workforce or school-day loss. Numerous surgical techniques have been described as the treatment of ingrown toenail, and the Winograd technique is a reliable procedure since first described at 1929. This paper presents a new and simple suture technique after the Winograd procedure for ingrown toenail. With this technique, I claim low rates of recurrence, and better and satisfactory cosmetic results. In this technical report; excision of the partial nail bed and lateral nail fold, including the inflammatory granulation tissue, is described. Through this procedure, maintaining skin fold under the nail is detailed aiming to reduce recurrence rates.

Neutralized Chemical Matricectomy with the Winograd Method in the Management of Ingrowing Toenail

ABSTRACT Background Ingrowing toenail is a common condition provoking pain, inflammation and functional limitation. Many surgical methods have evolved over the years for its treatment. The most important aspect of treatment of this problem is to prevent recurrence. The purpose of this paper was to study the effectiveness of combining the standard Winograd technique with neutralized chemical matricectomy to reduce the chances of recurrence and expedite postoperative recovery. Materials and methods Between 2006 and 2013, 33 patients (18 males, 15 females); with mean age 37.39 years (range 16 to 65 years) with 38 ingrowing toenails were treated with the standard Winograd technique combined with phenol matricectomy. The patients were evaluated in subsequent follow-ups for postoperative relapse, pain score (VAS) and time return to daily activities and ability to wear footwear and overall satisfaction. The mean follow-up period was 3.57 years (range 2 to 7 years). Results A total of 94.73% patients were satisfied with the overall outcome. The average return to normal shoe-wear was 1.54 weeks and the average return to normal activity was 1.18 weeks. Recurrence was seen in two patients (5.26%), 5 and 6 months after surgery. Four patients had delayed healing. None of the patients had any deep infection or neurovascular complications. Conclusion The Winograd technique when combined with neutralized phenol matricectomy is associated with a very low recurrence and infection rate. It allows early postoperative recovery and good cosmetic results with a high level of patient satisfaction. How to cite this article Agarwala S, Sobti AS, Mohrir G. Neutralized Chemical Matricectomy with the Winograd Method in the Management of Ingrowing Toenail. J Foot Ankle Surg (Asia-Pacific) 2014;1(2):55-59.

Cosmetic Results of Wedge Resection of Nail Matrix (Winograd Technique) in the Treatment of Ingrown Toenail

The purpose of this retrospective study is to evaluate the cosmetic results of wedge resection of the nail matrix (Winograd technique) in the treatment of ingrown toenail. This study retrospectively reviewed medical charts of 68 patients with 75 ingrown toenails who underwent surgical correction with the Winograd technique between January, 2008, and December, 2009, at the Orthopaedics and Traumatology Department, Antalya Education and Research Hospital. For the final follow-up, patients were contacted by telephone and completed a telephone questionnaire. Recurrence, cosmetic results, and satisfaction of the patients were the major outcome measures. There was recurrence in 9 patients (13.2%). The mean recurrence time was 6.7 months (range = 2-12 months). All recurrences involved the lateral border of the toenail. Cosmetic ratings were statistically lower in female patients (P = .005). The reasons for poor and acceptable cosmetic results were proximal-incision scar and narrowing of the nail plate. Wedge resection of nail matrix has a considerably high recurrence rate. Furthermore, narrowing of the nail plate is a disadvantage of this procedure. All patients should be informed about the possibility of recurrence and disfigurement in their toenails (narrow nail plate). Particularly, female patients who care about the cosmesis may be dissatisfied with this surgical technique.

Results of Partial Matrixectomy for Chronic Ingrown Toenail

Several treatment modalities which targeted partial matrixectomies, including chemical, laser matrixectomy, and partial nail avulsion, have been used in the dermatology, podiatry, and orthopaedic literature. We report our experience with surgical matrixectomy. We treated 224 patients with severe ingrowing toenails. Segmental wedge resection of involved margin was performed. Followup time was a minimum of 10 months. Statistical analysis of recurrence and disease parameters such as stage of disease, infection, involved margin, previous surgery, followup time, and age showed no significant correlation (p>0.05). Twenty-two patients (9.8%) had a recurrence. Revision surgery was performed in 16 patients (7.1%). We recommend the Winograd technique with a few modifications especially for severe Stage 2 and 3 cases. Both loupe magnification and observation of soft tissue in the postoperative period were important details.

Results Of The Winograd Technique In The Treatment Of Ingrowing Toe Nail

&#x0D; Ingrown toe nails are common in young people. This condition is painfull and may lead to time off work in addition to restricting recreational activities. Treatment ranges from changing foot wear to extensive surgical procedures. In this study, we evaluated the results of the technique described by Winograd in patients with ingrowing toe nail. The study included 28 patients (20 males, 8 females; mean age 25 years; range 14 to 56 years) who were treated with the technique describe by Winograd for ingrown toenails. A total of 31 ingrown nail edges were treated. According to the Heifetz's staging system, 14 patients had stage 2, 17 patients had stage 3 disease. The infected cases were operated on after improvement of inflammation by antibiotic treatment. Recurrences and satisfaction level of the patients were evaluated during a mean follow-up period of 22 months (range 12 to 36 months). Recurrence was seen in two patients (6.4%). 26 patients (92%) were satisfied with the treatment, with relief of their symptoms. Two patients who developed recurrences expressed dissatisfaction with surgery. The Winograd technique is a successfull surgical treatment of stage 2-3 ingrown toenails, with a relatively low recurrence rate and high levels of patient satisfaction.

Partial removal of nail matrix in the treatment of ingrowing toe nail

Ingrowing toe nail is a frequent disorder of the foot. In this study, we evaluated the results of surgical treatment of ingrowing toe nail. Sixty-two patients (31 males, 31 females; mean age 38 years; range 11 to 72 years) with ingrowing toe nail underwent partial removal of the nail matrix according to the Winograd technique. The presenting complaints were pain, foul-smelling drainage, deformity, and difficulty in walking. According to the Heifetz's staging system, 18 patients had stage I, 23 patients had stage II, and 21 patients had stage III disease. Forty-four patients had active drainage due to an infectious process. The infected cases were operated on after improvement of inflammation by antibiotic treatment. One patient underwent excision of subungual exocytosis causing severe deformity of the toe. Time to return to work, time to recurrence, and patient satisfaction were evaluated. The mean follow-up period was 26 months (range 24 to 42 months). Recurrence was seen in four patients (6.5%) within a mean of 4.2 months (range 3 to 7 months). The remaining patients returned to normal daily activities after a mean of 12 days (range 10 to 16 days). The mean time to work was five days (range 3 to 16 days). All but two patients who developed recurrences expressed satisfaction with surgery. None of the patients had deep infection or neurovascular complications. Partial removal of the nail matrix is associated with a very low recurrence rate and a higher rate of patient satisfaction.

VLSI architecture for the Winograd Fourier transform algorithm

A simple systotic architecture for the computation of the DFT using the Winograd Fourier Transform algorithm is presented. The architecture is shown to be problem-size independent and to satisfy the limited bandwidth constraint. By satisfying the above constraints, it is then shown to be naturally scalable within the limits allowed by the Winograd algorithm. The proposed architecture is compared with existing VLSI solutions using Winograd's technique. Lastly, the feasibility of deriving and using Winograd type algorithms for larger primes and prime-powers is studied.

Note a note on prime factor FFT algorithms

The author shows that prime factor FFT algorithms offer little improvement over conventional FFT algorithms on computers such as the Cray-1 and Cyber 205 where the multiplications can be performed in parallel with the additions. A very modest gain may be obtained by using Good's algorithm (1958) with conventional small-n transforms. Winograd's technique (1978), despite its impressive reduction in the number of multiplications, is likely to be slower than the conventional algorithm, particularly on the Cray-1, where memory transfers will dominate the computation. 13 references.