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Randomized, prospective study of nail bed ablation for recurrent ingrowing toenails
J H Anderson1, J D Greig, A J Ireland
1Department of Surgery, Hairmyres Hospital, East Kilbride, Glasgow, UK.
Journal of the Royal College of Surgeons of Edinburgh
|August 1, 1990
Summary
This study compared two surgical treatments for recurrent ingrowing toenails. Nail bed phenolization combined with excision significantly reduced postoperative infection rates compared to excision alone.
Area of Science:
- Podiatric surgery
- Dermatological surgery
Background:
- Ingrowing toenails (onychocryptosis) are a common condition often requiring surgical intervention.
- Recurrent cases, especially after multiple prior procedures, present significant treatment challenges.
- Previous surgical attempts may lead to nail bed deformities and increased complication risks.
Purpose of the Study:
- To compare the efficacy of nail bed excision versus combined nail bed excision and phenolization for recurrent ingrowing toenails.
- To evaluate postoperative infection rates and recurrence of nail spicules in two surgical groups.
Main Methods:
- A randomized controlled trial involving 31 patients with recurrent ingrowing toenails previously treated at least twice.
- Patients were assigned to either nail bed excision (Group A) or combined nail bed excision and phenolization (Group B).
- Outcomes including postoperative infection and recurrence were assessed at 2 weeks and 1 year.
Main Results:
- Group A (excision only) had a significantly higher postoperative infection rate (41%) compared to Group B (excision and phenolization) (7%) (P < 0.01).
- Recurrence of nail spicules at 1 year was observed in 59% of patients in Group A versus 43% in Group B.
- The combined approach demonstrated a trend towards lower recurrence rates, though not statistically significant in this series.
Conclusions:
- Combined nail bed excision and phenolization is a more effective treatment for recurrent ingrowing toenails, significantly reducing infection risk.
- High failure rates in treating recurrent onychocryptosis underscore the need for optimal primary treatment.
- Further research may explore long-term efficacy and patient-reported outcomes for combined surgical techniques.