Recurrent ingrown big toenails are efficiently treated by CO2 laser

Area of Science:

• Podiatry
• Dermatology
• Surgical Innovation

Background:

• Ingrown toenails (onychocryptosis) frequently recur after traditional surgical interventions.
• High recurrence rates necessitate exploring alternative treatment modalities for onychocryptosis.

Purpose of the Study:

• To assess the efficacy of carbon dioxide (CO2) laser partial matricectomy for treating recurrent ingrown toenails.
• To evaluate CO2 laser matricectomy as a solution for persistent onychocryptosis.

Main Methods:

• 196 patients with recurrent onychocryptosis, previously treated unsuccessfully, underwent CO2 laser partial matricectomy.
• The procedure involved nail avulsion followed by CO2 laser vaporization of the nail matrix, lateral horn, and nail groove.
• Patient follow-up extended to a minimum of 12 months post-procedure.

Main Results:

• A low recurrence rate of 1.45% (5 out of 344 margins) was observed, with recurrences primarily in bilateral procedures.
• Postoperative spicule formation occurred in 4% of treated margins, often associated with bilateral procedures or pre-existing infection.
• Wound healing was efficient, averaging 21.9 days, with no significant postoperative complications like infection or prolonged drainage.

Conclusions:

• CO2 laser partial matricectomy demonstrates high effectiveness in managing recurrent ingrown toenails.
• Bilateral procedures and local infection are identified as risk factors for recurrence and spicule development post-CO2 laser treatment.