Clinical Research on the Partial Excision of Nail Matrix Combined with Phenolic Ablation in the Treatment of Ingrowing Toenail / 现代生物医学进展

Objective:To investigate the clinical efficacy of partial excision of nail matrix combined with phenolic ablation in the treatment of ingrowing toenail.Methods:115 patients(148 toenails) with ingrowing toenail treated in the Central hospital of Wuhan from October 2004 to May 2013 were selected for this study.The patients were divided into two groups,53 patients(67 toenails) admitted from October 2004 to December 2007 were considered as the observation group and treated with Partial excision of nail matrix,62 patients(81 toenails) admitted from January 2008 to May 2013 were considered as the control group and treated with Partial excision of nail matrix and phenolic ablation.The bleeding time,pain relief time,healing time,recurrences after one year and satisfaction rate of two groups were compared.Results:The wounds of 148 toenails were healing.The Bleeding time,pain relief time,recurrences after one year in the control group (1.85:±:0.42days,13.25± 2.17hours) were lower than the observation group (2.69± 0.53 days,21.54± 2.56hours),and healing time in the control group (11.32± 2.37days) were longer than the observation group (8.93± 2.06 days)(P＜0.05),the recurrence rate and overall satisfaction rate of observation group and control group were 6.15％,12.5％ and 97.06％,91.07％.Conclusion:Partial excision of nail matrix combined with phenolic ablation was more effective in the treatment of ingrowing toenail than surgical excisional techniques.

Clinical Study of Efficacy of Super Elastic Wire for Ingrown Nails of Great Toe / 대한피부과학회지

BACKGROUND: Ingrown toenail is one of the most common nail complaints. It occurs mostly on the great toes, where is an excessive lateral nail growth into the nail fold, leading to painful irritation, inflammation, and growth of the granulation tissue. Many treatments have been described, but these classic treatment modalities may lead to severe damage of the nail fold or frequent relapses. OBJECTIVE: We attempted to evaluate the therapeutic efficacy of super elastic wire (SE-wire, Machiwire(R)), a non-invasive treatment for ingrown toenails. METHODS: Fifteen patients with ingrown toenail were treated with super elastic wire. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail root). Subjective assessment was evaluated by use of a visual analogue scale declared by patients. In addition, wound complications and recurrence were described. RESULTS: The width index and height index were improved (width index: 75.0%-->90.0%, height index: 76.5%-->27.7%). Pain was relieved in 100% of the cases. For subjective assessment, all of the patients were satisfied (more than "satisfactory": 100%). There were two relapsed cases during 5 to 12 month period (mean time: 9 months). CONCLUSION: We recommend super elastic wire method as an alternative treatment for ingrown toenail, because it is simple, easy to perform, noninvasive, effective, and well-tolerated.

Ingrown toenails.

Onychocryptosis or ingrown toenail is a very common pathology of the toenail unit, chiefly affecting adolescents and young adults. The ingrown toenail is responsible for disabling complaints like pain and difficulty in walking. It is associated with significant morbidity, hampering the quality of life as it interferes with sporting activities, school, or work. It principally occurs in the hallux. It is ascribed to poor trimming of the nails in combination with local pressure due to ill-fitting footwear, hyperhidrosis, poor foot hygiene and nail abnormalities. Pain, swelling and discharge are the main clinical features. Four stages of the condition have been described. Diagnosis is usually evident, but it should be differentiated from subungual exostosis and tumors of the nail bed. The current standard of care focuses on conservative treatment like the gutter splint technique in the initial stages, and in cases that are resistant to medical management or recurrent, surgical correction is the treatment of choice. There are various surgical techniques that are described in literature. Although there is no ideal technique, lateral nail plate avulsion with lateral matricectomy by phenol is commonly used and reported to be more effective in reducing recurrences. The aim of this review article is to focus on this common pathology of the nail, the various techniques employed in management and aid in the selection of treatment according to the stage and severity of the disease.

A Case of Ingrown Toenail Associated with Tinea Unguium Treated with K-D(R) Wire / 대한의진균학회지

Ingrown toenail is a common disorder resulting from various etiologies including excessive external pressure, ill-fitting footwear, and improper nail-trimming techniques. Patients commonly present with pain in the affected nail but with progression, drainage, infection and difficulty walking occur. It is often difficult to manage and frequently recurs, despite the multitude of treatment techniques that have been reported. Conservative therapy is a reasonable approach in patients with a mild to moderate ingrown toenail that do not have significant pain, substantial erythema, or purulent drainage from the lateral nail edge. We report a case of ingrown toenail in a 45-year-old female treated with K-D(R) wire, a corrective device. After application of K-D(R) wire for 3 weeks, ingrown toenail healed and the nail deformity was corrected.

A Treatment for Incurved Toenails Using a K-D(R)

Treatments of severely incurved toenails cause anatomical changes and cosmetic problems, even though they provide adequate symptom relief. Incurved toenail patients treated with a K-D(R)(S&C Biotech, Seoul, South Korea) the new device for correcting curved nail deformity were investigated retrospectively. This study surveyed 12 patients(18 cases) who had been treated for severe ingrown toenails using K-D(R) from May 2008 to March 2009, and examined their subjective satisfaction before and after the treatment. The average age of the participants was 39(ranging from 27 to 52), and 8 of them were male and 4 female. The treatment was applied after the patients were given a thorough explanation about the tool and the treatment, and questionnaire surveys were conducted before the treatment and after 3 months on the average from the treatment. In the survey, the respondents were asked about pain, restriction on activities, and the selection of shoes. For each item, symptoms with a given point were presented, and the respondents' scores were compared between the surveys before and after the treatment. According to the results of the questionnaire survey, pain increased from 14 out of 40 before the treatment to 39 after, activity restriction increased from 11 to 30, and shoe selection increased from 20 to 30. The average total score increased from 45 to 98, and this suggests a considerable enhancement in the patients' subjective satisfaction. The average period of the application of K-D(R) was 20.3+/-9.4 days, and in all the cases, ingrown toenails were corrected within three weeks.

The Effect of Removal of Granulation Tissue on Ingrown Toenails Associated with Granulation Tissue / 대한피부과학회지

BACKGROUND: Ingrown toenail is a common disorder that occurs most frequently in the big toe and gives affected patient great discomfort and pain. Granulation tissue of nail wall results from ulceration and inflammation by excessive contact between the nail edge and the soft tissues of the nail wall and induces aggravation of the ingrown toenail. OBJECTIVE: To decide whether removal of granulation tissue by electrocautery or not with lateral nail avulsion and matricectomy is the effective treatment in ingrown toenails with granulation tissue. METHODS: Randomized clinical trial with 12 month follow-up evaluations performed by observers. 33 patients with a total of 37 ingrown toenails were treated partial nail avulsion followed by mastricectomy and removal of granulation (granulation removal group), and 36 patients with 40 ingrown toenails were treated without removal of granulation tissue (control group). The determinations of effectiveness were based on the recurrence rate, duration of post-operative pain, wound healing time and post-operative infection. RESULTS: There was no significant difference in recurrence rates between the granulation removal group (15%) and control group (22%). There was a significant difference in the wound healing time between the granulation removal group (13.8 days) and control group (17.6 days). But there were no significant differences for the duration of post-operative pain and post-operative infection between the two groups. There were correlations between recurrence and duration of post-operative pain, wound healing time and post-operative infection. CONCLUSION: Procedures with granulation removal are an effective treatment for the treatment of ingrown nails, with the tendency of shorter times to reach complete recovery. But the effect of granulation removal has limited effect on reducing recurrence.