Electrodessication Matricectomy With Modified Hyfrecator Tip: Case Series and Literature Review

Abstract

Nail matricectomy is indicated in the management of painful onychodystrophies, including recalcitrant onychocryptosis, onychogryphosis, onychauxis, and refractory onychomycosis. Although many matricectomy methods have been described, with phenolization being the best studied, no one method has clearly emerged as superior. We present a series of 14 patients who underwent a total of 18 matricectomies with either phenolization or electrodessication (ED) in a private dermatology office, and describe a simple and effective variation of the ED technique using a modified hyfrecator tip. A video demonstration of this technique is included. We also describe ED matricectomy in the context of a review of the literature, ascertaining recurrence rates, complication rates, healing time, and patient satisfaction. The nuances of technique specifics (such as the use of adjunct methods and antibiotics), as well as outcome predictors and measurements have been highlighted. We found ED to be comparable to other forms of matricectomy, with the advantages of ease of use, minimal complications, and good satisfaction rates.

Matricectomy with Electrocautery as Therapy for Recurrent Ingrown Toenail

“…Some literatures reported that there is no significant difference between the results of matricectomy with electrocautery, phenol, and cryotherapy in the esthetical term. The ingrown toenail patients treated with these procedures had an adequately high satisfaction level in the aesthetical term with the minimal postsurgical wound [17][18][19]. In this report, patients did not complain related to any aesthetic disturbance either related to the big toe nail growth or shape after surgery.…”

“…Electrosurgery was one of the methods to treat ingrown nail that used high energy, while electrocautery only used a small electrical current utilizing the metal wires applied to the target tissue to burn or coagulate a specific tissue area and was then damaged. Electrocautery is a relatively safe procedure since the electrical energy does not flow through the patient's body, yet only affects the target tissue [17,18]. In this case series, electrocautery has been performed and chosen rather than electrodessication or electrofulguration because electrocautery is more appropriate for nonconductive tissues like nail, bone, and cartilage.…”