The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Randomized clinical trial of surgical technique and local antibiotics for ingrowing toenail. BJS 2007; 94: 292-296.

Published: 22nd February 2007

Authors: A. M. C. Bos, M. W. A. van Tilburg, A. A. van Sorge, J. H. G. Klinkenbijl

Background

The aim of this study was to investigate different surgical techniques for treating ingrowing toenails (IGTNs) and to determine the value of a locally applied antibiotic after intervention.

Method

One hundred and twenty‐three patients with IGTN were assigned randomly to one of four groups. All patients had partial nail avulsion. This was combined with excision of the matrix or application of phenol, with or without local application of gentamicin afterwards. All procedures were performed by one physician. The primary outcome measure was symptomatic recurrence of IGTN.

Results

One hundred and seventeen patients were available for follow‐up. Phenol gave significantly better results than matrix excision with respect to recurrence (including regrowth and spike formation) after 1 year (P < 0·001). In terms of signs of infection, there was no significant difference between phenol and matrix excision after 2 days (P = 0·224) or 1 week (P = 0·501). Antibiotics had no effect in reducing the risk of infection after 2 days (P = 0·989) or 1 week (P = 0·676), or in reducing the rate of recurrent IGTN at 1 year (P = 0·187). If regrowth or spike formation is included, the effect is even less significant (P = 0·876).

Conclusion

Partial nail avulsion with phenolization gave better results than partial avulsion with matrix excision. Local antibiotics did not reduce signs of infection or recurrence. Use of phenol did not produce more signs of infection than matrix excision. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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