Refining Nail Surgery: Clinical Pearls and Best Practices

Area of Science:

• Dermatology
• Surgical Science
• Oncology

Background:

• Nails are crucial for digit protection and function.
• Nail surgery poses challenges due to potential scarring and nail loss.
• Recent surgical advancements enhance treatment success and reduce complications.

Purpose of the Study:

• To review surgical management strategies for six key nail disorders.
• To synthesize clinical pearls and best practices in nail surgery.
• To provide a guide for practitioners on optimizing patient outcomes.

Main Methods:

• Literature review focusing on surgical interventions for specific nail conditions.
• Synthesis of evidence-based practices for ingrowing nails, pincer nails, onychogryphosis, glomus tumors, digital mucous cysts (DMCs), and nail unit melanoma (NUM).
• Analysis of recent advancements and innovations in nail surgery.

Main Results:

• Soft tissue excision is superior for recalcitrant ingrowing nails.
• Pincer nail correction requires addressing the nail bed to prevent recurrence.
• Onychogryphosis management involves nail grinding; glomus tumors require imaging confirmation before excision.
• DMCs can be treated with deroofing and chemical peeling; conservative NUM surgery is viable for early-stage cases.

Conclusions:

• Optimized surgical approaches improve outcomes for common nail disorders.
• Integrating current evidence and innovations refines nail surgery techniques.
• This review offers a comprehensive guide for dermatologic and surgical practitioners.