Best Surgical Option for Ingrown Toenails: A Sorely Needed Answer
Best Surgical Option for Ingrown Toenails: A Sorely Needed Answer
Bos AM, van Tilburg MW, van Sorge AA, Klinkenbijl JH
Br J Surg. 2007;94:292-296
The aim of this study was to determine the most effective surgical treatment for ingrown toenail. The study authors randomized 117 patients into the following treatment groups: partial nail avulsion + matrix plus antibiotics, partial nail avulsion + matrix no antibiotics, partial nail avulsion + phenol plus antibiotics, and partial nail avulsion + phenol minus antibiotics. All patients had partial nail avulsion. This was combined with excision of the matrix or application of phenol, with or without local application of gentamicin afterward. The measured endpoints were infection at 1 week and recurrence at 1 year. Infection rates were unrelated to the use of antibiotics (P = .13). However, recurrence rates were lower after phenolization of the nail bed (8 of 58) compared with excision of the nail matrix (23 of 59) (P = .002).
Ingrown toenail (unguis incarnatus) is a common, sometimes disabling condition that receives less attention than many other surgical conditions. This randomized trial suggested that partial nail avulsion with phenolization of the nail matrix is superior to partial nail avulsion with matrix excision. Antibiotics do not appear to be necessary. The 1-year recurrence rate of 14% in the partial excision phenol-treated group demonstrated that there is still room for improvement in the management of this minor surgical condition.
Abstract
Bos AM, van Tilburg MW, van Sorge AA, Klinkenbijl JH
Br J Surg. 2007;94:292-296
The aim of this study was to determine the most effective surgical treatment for ingrown toenail. The study authors randomized 117 patients into the following treatment groups: partial nail avulsion + matrix plus antibiotics, partial nail avulsion + matrix no antibiotics, partial nail avulsion + phenol plus antibiotics, and partial nail avulsion + phenol minus antibiotics. All patients had partial nail avulsion. This was combined with excision of the matrix or application of phenol, with or without local application of gentamicin afterward. The measured endpoints were infection at 1 week and recurrence at 1 year. Infection rates were unrelated to the use of antibiotics (P = .13). However, recurrence rates were lower after phenolization of the nail bed (8 of 58) compared with excision of the nail matrix (23 of 59) (P = .002).
Ingrown toenail (unguis incarnatus) is a common, sometimes disabling condition that receives less attention than many other surgical conditions. This randomized trial suggested that partial nail avulsion with phenolization of the nail matrix is superior to partial nail avulsion with matrix excision. Antibiotics do not appear to be necessary. The 1-year recurrence rate of 14% in the partial excision phenol-treated group demonstrated that there is still room for improvement in the management of this minor surgical condition.
Abstract
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