The Treatment of Ingrown Toenails: A Retrospective Study of Combined Wedge Resection with Phenol Versus Silver Nitrate Cauterization
DOI:
https://doi.org/10.17140/DRMTOJ-3-130Keywords:
Primary care, Phenol, Silver nitrate, Ingrown toe nails, Doha, QatarAbstract
Aim
The aim of the current study is to retrospectively review the efficacy of phenol versus silver nitrate matricectomy for treating ingrown
toenails.
Methods
A total of 132 charts for ingrown toenails treated at Umm Ghuwailina Primary Health Care Center, Doha, Qatar were retrospectively
reviewed for association with socio-demographic characteristics, infection rate, pain level, duration of treatment, treatment
modalities and their outcomes.
Results
A total of 64 phenol ablations and 68 silver nitrate ablations were performed on patients with stages II and III diseases.
The patients were reviewed daily until the achievement of full wound healing and later on, they were regularly followed-up for a
mean period of 36 months. In the phenol group, the healing period post-operatively ranged from 2 to 4 weeks with no post-operative
complications including loss of sensation or nail spikes with only one recurrence (0.57%) were observed, after 16 months. On
the other hand, the silver nitrate group had a longer healing period ranging from 4 to 10 weeks with post-operative complications
ranging from post-operative nail bed infection (soft tissue necrosis) (43%), post-operative pain (65%). The success rate was found
to be 98.8%. Treatment with phenol therapy and 96% with silver nitrate therapy respectively.
Conclusion
We conclude that both phenol and silver nitrate cauterization are an excellent method for the treatment of ingrowing toenail.
However, phenol is far superior to silver nitrate due to its simplicity, low morbidity, pain-free course post-operatively, no postoperative
infection, better satisfaction and high success rate. Before surgical intervention, 79% of patients had a severe pain score,
72% had difficulty wearing their normal footwear and 65% had the restriction of normal activities due to their ingrown toenails.
Overall, 100% of phenol arm were satisfied (n=63) with the procedure whereas in the silver nitrate arm only 82% (n=56) were
satisfied. No loss of sensation at the surgical site was reported in either of the arms.
References
Rounding C, Bloomfield S. Surgical treatments for ingrow-ing toenails. Cochrane Database Syst Rev. 2005; 2: CD001541. doi: 10.1002/14651858.CD001541.pub2
Cöloglu H, Koçer U, Sungur N, et al. A new anatomical repair method for the treatment of ingrown nail: Prospective comparison of wedge resection of the matrix and partial matricectomy fol-lowed by lateral fold advancement flap. Ann Plast Surg. 2005; 54: 306-311. discussion 312.
Kruijff S, van Det RJ, van der Meer GT, et al. Partial matrix excision or orthonyxia for ingrowing toenails. J Am Coll Surg. 2008; 206: 148. doi: 10.1016/j.jamcollsurg.2007.06.296
Zuber TJ. Ingrown toenail removal. Am Fam Physician. 2002; 65: 2547.
Bos AM, van Tilburg MW, van Sorge AA, et al. Randomized clinical trial of surgical technique and local antibiotics for ingrow-ing toenail. Br J Surg. 2007; 94: 292. doi: 10.1002/bjs.5691
Gupta S, Sahoo B, Kumar B. Treating ingrown toenails by nail splinting with a flexible tube: An Indian experience. J Dermatol. 2001; 28: 485. doi: 10.1111/j.1346-8138.2001.tb00016.x
Laxton C. Clinical audit of forefoot surgery performed by regis-tered medical practitioners and podiatrists. J Public Health Med. 1995; 17(3): 311-317. doi: 10.1093/oxfordjournals.pubmed.a04312
Vandenbos K, Bowers W. Ingrowing toenail: A result of weight bearing on soft tissue. U S Armed Forces Med J. 1959; 10: 1168-1173.
Antrum RM. Radical excision of the nailfold for ingrowing toe-nail. J Bone Joint Surg Br. 1984; 66: 63. Retrospective Study | Volume 3 | Number 1|
Yang KC, Li YT. Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser. Dermatol Surg. 2002; 28: 419-421. doi: 10.1046/j.1524-4725.2002.01245.x
Arai H, Arai T, Nakajima H, Haneke E. Improved conservative treatment of ingrown nail—acrylic affixed gutter treatment, sculp-tured nail, taping, sofratulle packing, super elastic wire, plastic nail brace and nail ironing. Japanese Journal of Clinical Dermatology. 2003; 57(5): 110-119.
Bostanci S, Kocyigit P, Gürgey E. Comparison of phenol and sodium hydroxide chemical matricectomies for the treatment of ingrowing toenails. Dermatol Surg. 2007; 33(6): 680-685. doi: 10.1111/j.1524-4725.2007.33143.x
Kocyigit P, Bostancı S, Özdemir E, Gürgey E. Sodium hydrox-ide chemical matricectomy for the treatment of ingrown toenails: Comparison of three different application periods. Dermatol Surg. 2005; 31(7): 744-747.
Tatlican S, Eren C, Yamangokturk B, Eskioglu F. Retrospective comparison of experiences with phenol and sodium hydroxide in the treatment of Ingrown nail. Dermatol Surg. 2010; 36(3): 432-434. doi: 10.1111/j.1524-4725.2009.01466.x
Kim SH, Ko HC, Oh CK, Kwon KS, Kim MB. Trichloroacetic acid matricectomy in the treatment of ingrowing toenails. Dermatol Submit your article to this journal | https://openventio.org/submit-manuscript/ Retrospective Study | Volume 3 | Number 1| Mohamed H, et al Surg. 2009; 35(6): 973-979. doi: 10.1111/j.1524-4725.2009.01165.x
Rounding C, Bloomfield S. Surgical treatments for ingrow-ing toenails. Cochrane Database Syst Rev. 2005; 2: CD001541. doi: 10.1002/14651858.CD001541.pub2
de Berker DA. Phenolic ablation of the nail matrix. Aus-tralas J Dermatol. 2001; 42(1): 59-61. doi: 10.1046/j.1440- 0960.2001.00477.x
Noël B. Surgical treatment of ingrown toenail without matri-cectomy. Dermatol Surg. 2008; 34(1): 79-83.
Thommasen HV, Johnston CS, Thommasen A. The occasional removal of an ingrowing toenail. Can J Rural Med. 2005; 10(3): 173- 180.
Rounding C, Bloomfield S. Surgical treatments for ingrow-ing toenails. Cochrane Database Syst Rev. 2005; 2: CD001541. doi: 10.1002/14651858.CD001541.pub2
Burzotta JL, Turri RM, Tsouris J. Phenol and alcohol chemical matrixectomy. Clin Podiatr Med Surg. 1989; 6(2): 453-467.
Chapeskie H, Kovac JR. Soft-tissue nail-fold excision: A defini-tive treatment for ingrown toenails. Can J Surg. 2010; 53(4): 282- 286.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Dermatology (DER) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
