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Nail unit incision lines: A tool to minimize nail unit scarring
Chander Grover1, Shikha Bansal2, Somesh Gupta3
1Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India.
Journal of Cutaneous and Aesthetic Surgery
|December 9, 2024
Summary
Nail unit incision lines (NUIL) guide surgeons for optimal nail regrowth and reduced scarring. Understanding and following NUIL orientation is crucial for successful nail surgery outcomes.
Area of Science:
- Dermatology and Plastic Surgery
- Surgical Anatomy
Background:
- Established skin tension lines (Langer's, BEST lines) guide cutaneous surgery to minimize scarring.
- Nail unit incision lines (NUIL) are crucial for normal nail regrowth but are not widely understood in nail surgery.
Purpose of the Study:
- To describe nail unit incision lines (NUIL) for improved outcomes in nail surgery.
- To emphasize the importance of respecting NUIL for minimizing scarring and promoting nail regeneration.
Main Methods:
- Review and description of anatomical considerations for nail unit incisions.
- Analysis of optimal incision orientations based on specific nail unit structures.
Main Results:
- Nail bed incisions should be longitudinal; nail matrix incisions should be horizontal.
- Lateral nail fold incisions should be longitudinal; proximal nail fold incisions should be radial.
- Distal nail fold (hyponychial) incisions should align with the distal nail ridge.
Conclusions:
- Adherence to NUIL principles is essential for minimizing scarring in nail surgery.
- Proper orientation of incisions optimizes the potential for normal nail regrowth.
- NUIL provide a framework for consistent and effective surgical technique within the nail unit.
