Efficacy and safety of phenol‐based partial matricectomy in treatment of onychocryptosis: A systematic review and meta‐analysis

Abstract

Chemical matricectomy is an established treatment modality of onychocryptosis. In this meta‐analysis, we studied the efficacy and safety profile of phenol‐based matricectomy. We performed an electronic database search of PubMed, EMBASE and grey literature using the search terms ‘(onychocryptosis OR ingrown toe nail) AND (phenol OR chemical matricectomy)’ from inception till 31‐12‐2020, for controlled clinical trials with phenol in one of the treatment arms and at least 10 participants in each arm. From the initial search of 335, eighteen articles were included in the final analysis. There were a total of 1655 patients, of which 856 received phenol as an intervention modality. We found that nail matrix phenolisation was associated with a 49 fewer number of recurrences per thousand patients compared with other modalities (OR: 0.28–0.57, CI 95%). It also had a reduction in 175 cases of discharge or haemorrhage per thousand patients compared with other modalities (OR: 0.25, 95% CI: 0.14–0.45). However, we found that TCA‐ and NaOH‐based matricectomies fared better compared with phenol in incidence of postoperative discharge and haemorrhage. Patients also experienced less pain (257 fewer number per 1000, OR: 0.52, 95% CI: 0.43–0.63). Nearly, half of the included studies had some concerns about the risk of bias. As of now, phenol matricectomy combines a low recurrence rate with favourable adverse effect profile and is the preferred modality for matricectomy in grade II and III onychocryptosis.

A systematic review and meta‐analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms

“…The systematic, search identified 1,641 potential publications which, after screening, enabled 36 studies with 3,756 participants covering a range of techniques that were included in the review. This is a substantial increase on the 24 and 18 studies in the previous Cochrane review [4], and the review by Vinay and colleagues [13], respectively. Recurrence was reported in all but one study, although there were variations in how this was defined and captured.…”

Comparative efficacy of S-shaped partial nail fold resection combined with lateral groove reconstruction and matrix phenolization on onychocryptosis: a retrospective study

“…Matrix phenolization is the recommended non-incisional surgical treatment for onychocryptosis 17,19,25 . Swab with a cotton ball soaked in phenol was applied to the zone of the matrix and the nail bed based on the portion of the nail plate was removed.…”

“…Nail phenolization is a common procedure for patients with onychocryptosis at early stage, which is simple, inexpensive, and associated with little postoperative discomfort and recurrence 17 . However, nail phenolization is not suitable for onychocryptosis at stage IV as the distal edge of nail plate has been embedded entirely by the swollen hyponychium and nail phenolization cannot resolve the condition thoroughly.…”

Häufige Nagelerkrankungen im Kindes- und Jugendalter

“…Eine bewährte Therapiemethode beim eingewachsenen Zehennagel ist die seitliche Nagelteilextraktion

Nagelteilextraktion

mit anschließender Phenolverödung des seitlichen Matrixhorns (Chemokaustik) [ 40 ]. Die Rezidivraten sind bei diesem Verfahren gering, über 80 % der Patienten können mit dem einmaligen Eingriff geheilt werden [ 41 ]. Aufgrund der einfachen Durchführung, Effektivität und guter Verträglichkeit hat die seitliche Nagelteilextraktion mit anschließender Chemokaustik des seitlichen Matrixhorns die klassische sog.…”