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Surgical treatments for ingrowing toenails
1UK Cochrane Centre, Summertown Pavilion, Middle Way, Oxford, Oxfordshire, UK, OX2 7LG. crounding@cochrane.co.uk
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Surgical treatment for ingrowing toenails using phenol with nail avulsion is more effective than excisional surgery. However, adding phenol increases post-operative infection risk despite reducing recurrence.
Area of Science:
- Podiatry
- Surgical Innovation
- Dermatology
Background:
- Ingrowing toenails (onychocryptosis) are a common condition requiring effective surgical management.
- Recurrence of symptoms is a significant concern following surgical intervention.
- Various surgical techniques exist, each with varying efficacy and complication rates.
Purpose of the Study:
- To evaluate and compare the effectiveness of different surgical treatment methods for ingrowing toenails.
- To assess the long-term recurrence rates associated with various surgical approaches.
- To determine the impact of phenol on recurrence and complication rates.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and quasi-randomized trials.
- Searched electronic databases including CENTRAL, MEDLINE, EMBASE, and CINAHL.
- Included studies with a minimum six-month follow-up aiming for permanent nail removal.
Main Results:
- Nail avulsion with phenol is more effective than excisional surgery in preventing recurrence at six months or more (OR 0.44).
- Adding phenol to nail avulsion significantly reduces symptomatic recurrence (OR 0.07).
- The use of phenol is associated with a significant increase in post-operative infection rates (OR 5.69).
Conclusions:
- Simple nail avulsion combined with phenol is superior to excisional techniques for preventing ingrowing toenail recurrence.
- Phenol significantly decreases recurrence but increases the risk of post-operative infection.
- Optimal surgical strategies for ingrowing toenails should balance efficacy and complication risks.