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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
|April 23, 2005
Summary
Surgical treatment for ingrowing toenails using phenol combined with nail avulsion is more effective than excisional surgery for preventing recurrence. However, phenol use increases post-operative infection risk.
Area of Science:
- Podiatric surgery
- Dermatological surgery
Background:
- Ingrowing toenails (onychocryptosis) are a prevalent condition.
- Recurrent and painful cases often necessitate surgical intervention.
Purpose of the Study:
- To systematically evaluate the efficacy of different surgical treatment methods for ingrowing toenails.
Main Methods:
- Conducted a comprehensive search of electronic databases (CENTRAL, MEDLINE, EMBASE, CINAHL) and reference lists.
- Included randomized or quasi-randomized controlled trials comparing surgical nail removal techniques with a minimum six-month follow-up.
- Extracted data independently and analyzed categorical outcomes using odds ratios and 95% confidence intervals.
Main Results:
- Phenol combined with nail avulsion demonstrated superior effectiveness in preventing symptomatic recurrence compared to excisional procedures (OR 0.44).
- Adding phenol to nail avulsion significantly reduced recurrence rates (OR 0.07) but increased post-operative infection rates (OR 5.69).
Conclusions:
- Nail avulsion with phenol is more effective than excisional techniques for preventing ingrowing toenail recurrence.
- While phenol significantly decreases recurrence, it is associated with a higher risk of post-operative infection.