Segmental phenolic ablation for ingrown toenails in general practice

Ingrown toenails cause a great deal of discomfort and may result in missed time from school, work and sports. Traditionally, this problem was quickly dealt with by a simple nail avulsion or wedge avulsion in general practice, Accident and Emergency departments or O.P.D.s. However, this treatment has a high relapse rate (73%). In this survey ingrown toenails were treated by wedge resection and ablation of the nail bed with 80% fresh phenol under ring block anaesthesia and a bloodless field. The aim of this prospective study was to assess the feasibility, cure rate and complications of Segmental Phenolic Ablation for ingrown toenails in general practice. A prospective analysis of 201 consecutive Wedge Resections and Phenol Ablations for ingrown toenails in 111 patients by one General Practitioner over a five and a half year period. All patients were followed up for at least six months post-operatively. There was a relapse rate of 4.5%. Two-thirds of the recurrences occurred in patients who had relapsed after previous surgery before entering this study. All recurrences were successfully treated by repeat phenol cauterisation. The relapse rate for cases who had never been previously operated on (137 edges) was 2.2% (3 edges). There were no major peri-operative or post-operative complications. No patient had to be referred to hospital for treatment of their ingrown toenails. Wedge Resection and Phenol Ablation for ingrown toenails can be carried out safely and successfully in general practice and is recommended as the surgical treatment of choice.