Modified procedure effective for advanced-stage ingrown toenails

By Stephanie Leveene, medwireNews Reporter

Partial excision of the proximolateral matrix combined with phenolic ablation is an effective treatment for ingrown toenails, indicate findings showing good long-term success rates.

Results of this first study to assess a modified Zadik technique to treat patients with stage 2 or 3 ingrown toenails are published in the Annals of Family Medicine.

Nezih Karaca (Okmeydani Education and Research Hospital, Istanbul, Turkey) and Tugrul Dereli (Ege University Medical Faculty, Izmir, Turkey) treated 225 adults with 384 ingrown toenails. Healing time was 2 to 4 weeks and all patients were satisfied with the cosmetic outcome at 2 years.

Only one recurrence of ingrown toenail was noted 8 months after the procedure. This patient was subsequently retreated and did not have any additional recurrences during 2 years of follow up.

Using the regular Zadik technique for total nail bed ablation has been shown to cause significant postoperative pain and recurrence rates of up to 28%, explain Karaca and Dereli.

The authors modified the procedure by making a longitudinal incision in the side of ingrown toenail, conducting a partial rather than total matrix extraction, and adding cauterization with liquid phenol. Use of the latter ablation procedure helps to prevent future growth of the lateral nail plate into the proximolateral nail fold.

The authors note that there study did not have a control group and say that there is a need for controlled studies using their technique.

Nevertheless, they believe that "our technique, using several treatments in a single procedure, ranks as one of the best for preventing recurrence and achieving a high success rate," especially over the long term.

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