Hemostatic Efficacy of Absorbable Gelatin Sponges for Surgical Nail Matrixectomy after Phenolization—A Blinded Randomized Controlled Trial

Abstract

Background: Some studies have recommended combining germinal matrix excision with phenol ablation in the treatment of onychocryptosis. Matrixectomy after phenolization has been shown to be an effective modification to reduce the drawbacks associated with phenolization alone, although it increases the risk of minor postoperative bleeding. The present study aims to assess the effectiveness and safety of gelatin sponges as hemostatic agents in partial matrixectomy after phenolization. Methods: A comparative clinical trial in parallel groups was designed in 74 halluces (44 patients) with stage I, II, and III onychocryptosis. All participants were randomly assigned to 3 groups: Group A (control group), Group B (conventional gelatin sponge), and Group C (high porosity gelatin sponge). Results: The quantified mean blood loss in the first 48 h after surgery in patients in both experimental groups was significantly lower compared to the control group. The lowest mean blood loss was recorded in Group C (p < 0.001) and followed by Group B (p = 0.005). No adverse effects were recorded in any of the patients included in the experimental groups. Conclusions: Hemostatic gelatin sponges were demonstrated to be effective and safe devices for the control of minor postoperative bleeding associated with matrixectomy after segmental phenolization.

Hallux Partial Necrosis Associated with Antiphospholipid Syndrome: The Importance of Early Accurate Diagnosis

“…As in the present case, in minor surgical procedures, the application of topical hemostatic devices such as gelatin sponges has been shown to be effective. Gelatin sponges can be very useful alone or in combination with antifibrinolytic agents in patients undergoing nail surgery and who are treated with pharmacological drugs that inhibit blood coagulation [23].…”