[Unguis incarnatus-conservative or operative treatment? A practical treatment algorithm]

Onychocryptosis: a retrospective study of clinical aspects, inflammation treatment and pain management using Ozoile as a hydrogel and cream formulation

Ingrown toenails account for roughly 20% of all foot problems in primary care. It is most common in young men, with nail care habits and footwear being major contributors. Onychocryptosis is typically caused by self-treatment attempts to cure the condition in its early stages. Its clinical features are frequently confused with other osseous and soft tissue abnormalities. The goal of this study was to provide perspectives on the management of pain and inflammation in Onychocryptosis using an Ozoile-based hydrogel formulation in a semi-occlusive bandage for 14 days, while incorporating natural pharmacological solutions into established protocols. The primary outcomes measured were pain reduction on NRS and stadiation according to the Al Kline Classification. The reduction was statistically significant, with a mean decrease in VAS score from 10 to 4 (p < 0.05), and Al Kline classification decreased by an average of 1.6 stages. 42% of patients recovered within the first 15 days of treatment, and 93% by the end of the scheduled treatment.

[Emmert's plastic surgery]

OBJECTIVE

The aim of the surgical intervention is the elimination of infections, ulceration and pain caused by ingrown nails (unguis incarnatus).

INDICATIONS

A surgical intervention is recommended for ingrown nails (the large toenail is most frequently affected) in stage III and higher (according to the Mozena classification) as well as in cases of nail plate defects and recurrences.

CONTRAINDICATIONS

In cases where a disturbance of wound healing is expected and general contraindications for surgery.

SURGICAL TECHNIQUE

The surgical approach incorporates a half-moon-shaped skin incision and a straight longitudinal nail incision. Both incisions extend to the bone. A wedge-shaped piece of tissue is removed and after thorough curettage and rinsing the wound is closed using transungual single-button sutures.

POSTOPERATIVE MANAGEMENT

Regular changes of wound dressing, relief of the affected ray by immobilization during wound healing. An antibiotic therapy is only indicated in selected cases.

RESULTS

Between 1 January 2013 and 1 January 2023 a total of 50 Emmert's plastic surgery operations (15 women and 35 men) were performed at the Klinikum Vest, Knappschaftskrankenhaus Recklinghausen. The average age of the patients was 50.6 years. The mean follow-up time was 63 months. The outcome and satisfaction of the patients were evaluated according to the self-reported foot and ankle score (SEFAS). The total point count (median value) of the evaluated SEFAS score was 44.

Ingrown Toenails: A Survey Among Dermatologists on Current Treatments

BACKGROUND

To date, there is no formal consensus on how to treat ingrown toenails. Despite the risk of causing irreparable damage to the nail, highly invasive procedures are still common. Less-invasive, matrix-directed techniques with shorter downtime and high cure rates exist, but, perhaps because of a lack of awareness, appear not to have been universally adopted.

OBJECTIVE

The authors' study sought to generate data on common practices in the treatment of ingrown toenails.

MATERIALS AND METHODS

The authors developed and conducted an online survey to ask dermatologists/dermatosurgeons how they would proceed in 9 different cases of ingrown toenails based on photographs.

RESULTS

The authors received 154 replies. Nonsurgical interventions, including advice on nail care/foot baths/ointments/wraps/padding, were always the most frequently chosen option. Removal of the lateral nail plate followed by chemical partial matricectomy (phenolization) was the most or second-most frequently chosen surgical intervention. The answers were highly heterogeneous, and there was no unanimity based on morphology alone.

CONCLUSION

Except for a preference for nonsurgical interventions, the authors could not identify any clear treatment standards. The heterogeneity of treatment approaches suggests the need for a guideline.