Total nail ablation for onychodystrophy with optimized gauze–phenol application

Becerro-de-Bengoa-Vallejo, Ricardo; Iglesias, Marta Elena Losa; Alou, Luís; Fernández, David Sevillano; Prieto, J.

doi:10.1111/j.1468-3083.2010.03569.x

Cited by 12 publications

(21 citation statements)

References 41 publications

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“…This option shows beneficial effects, such as strong antiseptic properties, production of necrosis during protein coagulation, and reduction of pain due to nerve fiber demyelination in the nail unit [11,12]. Nevertheless, chemical matricectomy with 88% phenol solution may produce a delay in the healing time (between 21 and 42 days) related to tissue destruction, excessive drainage, and an adverse reaction to the phenol solution [10,[13][14][15]. On the other hand, incisional surgical options are indicated for advanced stages with hypertrophy of the nail folds.…”

Section: Introductionmentioning

confidence: 99%

The Treatment of Ingrown Nail: Chemical Matricectomy With Phenol Versus Aesthetic Reconstruction. A Single Blinded Randomized Clinical Trial

Muriel-Sánchez

Becerro-de-Bengoa-Vallejo

Montaño‐Jiménez

et al. 2020

JCM

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Background: In onychocryptosis surgery, incisional and non-incisional matricectomy is indicated according to the stage. The chemical matricectomy with 88% phenol solution is the gold standard and a wedge resection is indicated for more advanced stages. The aesthetic reconstruction has the advantages of the incisional procedure without eponychium incisions and an effectiveness similar to the chemical matricectomy with phenol. Objective: To compare the recurrence and the healing time between the chemical matricectomy with phenol and the aesthetic reconstruction. Methods: A comparative, prospective, parallel, randomized, and one-blinded clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2019-001294-80. Thrity-four patients (56 feet) with 112 onychocryptosis were randomized in two groups. Thirty-six were treated with chemical matricectomy with phenol and 76 with aesthetic reconstruction. Each patient was blind to the surgical procedure assigned by the investigator. The primary outcome measurements were healing time and recurrence. The secondary outcome measurements were post-surgical bleeding, pain, inflammation, and infection rate. Results: The aesthetic reconstruction procedure presents a shorter healing time (8.2 ± 1.4 days vs. 21.3 ± 3.1 days; p < 0.001) with a similar recurrence rate (p = 0.98). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The aesthetic reconstruction presents a shorter healing time, favoring the patients’ recuperation, with a recurrence similar to the chemical matricectomy with 88% phenol solution.

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Section: Introductionmentioning

confidence: 99%

The Treatment of Ingrown Nail: Chemical Matricectomy With Phenol Versus Aesthetic Reconstruction. A Single Blinded Randomized Clinical Trial

Muriel-Sánchez

Becerro-de-Bengoa-Vallejo

Montaño‐Jiménez

et al. 2020

JCM

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“…Total permanent nail ablation for the treatment of severe nail dystrophies involving the nail plate can be performed by total surgical nail matrix excision and total ablation of nail matrix with electrocautery, chemicals or laser [1][2][3] .…”

Section: Discussionmentioning

confidence: 99%

“…Clinical results of phenol cauterization of nail matrix compares favorably with surgical ablation [1,2] . Phenol cauterization results in fewer nail spicule formation and less postoperative pain [1,2] . However, addition of bilateral nail matrix horn ablation by using electrocautery will decrease the risk of postoperative spicule formation greatly following surgical total nail matrix excision.…”

Section: Discussionmentioning

confidence: 99%

“…When a nail becomes severely deformed permanent total ablation of the nail is the best choice of treatment [1] . Here we describe a case with severe bilateral great toe onychodys tro phy treated by total surgical nail matrix excision followed by plantar skin coverage of dorsal aspect of dis tal part of great toe by using a novel flap technique for pro vid ing protection in the absence of a nail plate.…”

Section: Introductionmentioning

confidence: 99%

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A novel surgical method for total nail ablation: Use of triple flap technique

Aksoy

2017

J Surg Dermatol

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<p>Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix.<strong> </strong>A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. </p>

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“…Se aplicó el mismo protocolo y procedimiento quirúrgico a todos los sujetos del estudio, siguiendo la técnica de Becerro de Bengoa y cols. 2 . Por lo tanto, la diferencia entre los grupos consistió únicamente en el protocolo de curas posteriores a la cirugía, cuando se crearon dos grupos (seleccionados al azar).…”

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The effect of controlled flux electrolyzed acid solution (SAEFC) protocol in the recovery of phenol total matricectomy: A randomized controlled trial

Nova¹

2019

Rev. Esp. Pod.

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Efecto de la solución ácida electrolizada de flujo controlado (SAEFC) en el tiempo de recuperación de matricectomías totales con fenol: ensayo clínico aleatorizadoThe effect of controlled flux electrolyzed acid solution (SAEFC) protocol in the recovery of phenol total matricectomy: a randomized controlled trial Palabras clave:Matricectomía total, fenol, protocolo, curas, solución ácida electrolizada de flujo controlado (SAEFC). ResumenIntroducción: Existen diferentes tipos de protocolos de curas en matricectomías químicas totales. Recientemente, la solución ácida electrolizada de flujo controlado (SAEFC) ha sido usada para tratar quemaduras. Así, el objetivo de este estudio fue comparar el tiempo de cicatrización total y la carga bacteriana en dos tipos de curas.Pacientes y métodos: Sobre 28 matricectomías químicas totales, en la primera cura posquirúrgica, se realizaron aleatoriamente dos tipos de curas: grupo 1 aplicación de SAEFC (manteniendo húmedo el vendaje); grupo 2, curas diarias con povidona yodada en gel. Se realizó un contaje de unidades formadoras de colonias en la primera visita posquirúrgica y a los tres días. La evolución fue seguida cada tres días para determinar el tiempo de cicatrización total.Resultados: La media de los días de recuperación fue menor (29.2 ± 3.2) en el grupo 1 que en el grupo 2 (34.3 ± 4.1) (p = 0.023). En la primera visita posquirúrgica no hubo diferencias (p > 0.05) en la carga bacteriana entre los grupos. En el segundo cultivo (5 días después de la cirugía) la carga bacteriana en el grupo 1 fue 0.42 ± 0.38 × 10 4 y en el grupo 2, 0.63 ± 0.48 × 10 4 siendo la diferencia estadísticamente significativa entre ambos (p = 0.012).Conclusión: En las matricectomías químicas totales, el protocolo de curas son la solución ácida electrolizada de flujo controlado (SAEFC) proporciona una reducción de cinco días en el tiempo de recuperación. Además, la menor carga bacteriana observada con este protocolo de curas puede ayudar a prevenir las infecciones en la cirugía ungueal. AbstractIntroduction: There are different cures protocols to manage total chemical matricectomies. Recently, the controlled flux electrolyzed acid solution has been used to treat burns, so, the aim of the study was to compare the total healing time and bacterial load in two types of cures.Patients and methods: In a sample of 28 chemical total matricectomies, in the first postoperative visit (48 h), two groups were made at random: group 1, applying of controlled flux electrolyzed acid solution (maintaining ever wet the bandage); group 2 (iodate povidone in gel) were made. A count of bacterial colony forming units was taken at this postoperative visit and three days later. Also, the evolution of both groups was followed every three days, to determine the total healing time.Results: Mean days of discharge were lower (29.2 ± 3.2 days) in the Group 1 than in group 2 (34.3 ± 4.1) (p = 0.023). The bacterial load at the 48 hours first visit was not different between groups, (p > 0.05). At the second culture (5 days after the su...

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Total nail ablation for onychodystrophy with optimized gauze–phenol application

Abstract: Phenol-based total nail ablation with specific gauze application is safe, inexpensive and has a high rate of patient satisfaction.

Cited by 12 publications

References 41 publications

The Treatment of Ingrown Nail: Chemical Matricectomy With Phenol Versus Aesthetic Reconstruction. A Single Blinded Randomized Clinical Trial

The Treatment of Ingrown Nail: Chemical Matricectomy With Phenol Versus Aesthetic Reconstruction. A Single Blinded Randomized Clinical Trial

A novel surgical method for total nail ablation: Use of triple flap technique

The effect of controlled flux electrolyzed acid solution (SAEFC) protocol in the recovery of phenol total matricectomy: A randomized controlled trial

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