Exploring postoperative outcomes for ingrown toenails. NaOH vs wedge resection techniques

Abstract

Background: Ingrown (or ingrowing) toenail is a commonly used term for onychocryptosis, in which the nail becomes inserted into the lateral fold of the toe. The resulting effect on a person's health, well-being, and ability to work suggests the importance of clear treatment guidance, but little consensus exists.

Objective: To explore postoperative recovery after surgery for ingrown toenails using chemical (sodium hydroxide (NaOH)) or mechanical (wedge resection) matricectomy and thus contribute to understanding within the field on which to base treatment guidelines.

Methods: One hundred sixty-one procedures were undertaken, 94 using NaOH and 67 using wedge resection. Four measures of postoperative recovery were recorded: recurrence, infection, time to discharge, and number of postoperative visits.

Results: Patients treated with NaOH had lower rates of recurrence (p = .048) and infection (p = .03) than those treated with wedge resection, and time to discharge was shorter (p = .02), but they had more postoperative visits (p = .003).

Conclusion: Low rates of recurrence and infection and short postoperative recovery time were found after both procedures, with a small advantage with treatment with NaOH. The authors argue for the value of clinical intervention using matricectomy in early stages to avoid complications resulting from granulation tissue growth.