Alcohol irrigation after phenol chemical matricectomy: an in vivo study

For treatment of ingrown toenails, a phenolization is often chosen. Many reports describe an intra-operative irrigation, or lavage, of the wound with alcohol to neutralize any residual phenol. There are conflicting reports in the literature as to whether a true neutralization is required or merely effective removal of excess phenol. We hypothesized that intra-operative irrigation with 70% alcohol after the application of phenol does not remove enough phenol and a quantity of phenol still remains in the wound nail fold performing its action.

The aim of our study was to analyze the suitability and effectiveness of the alcohol lavage step during the treatment of ingrown toenails with a phenolization procedure.

We performed an in vivo study in 29 patients who underwent unilateral phenol chemical matricectomy to measure the amount of phenol remaining after five irrigations with a total of 15 ml of alcohol.

There were measurable amounts of phenol collected after five alcohol irrigation steps, suggesting that phenol was not neutralized by the alcohol. After the first irrigation, only 45.74% of phenol was eliminated. An additional 12 ml of alcohol were necessary to eliminate the remaining 54.25% in the nail bed.

A single alcohol lavage step after the phenolization procedure did not eliminate enough phenol. However, 15 ml of alcohol can serve as a suitable and effective means of diluting and removing any excess or residual phenol from the exposed area by its drag effect.