The effectiveness of nail excision versus Vandenbos procedure for the surgical management of ingrown toenails in children: A retrospective chart review

Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements

Ingrown toenail (IGTN), known as onychocryptosis or unguis incarnatus, is a painful condition affecting the big toe, with symptoms including pain, inflammation, and infection. This review explores surgical options for IGTN, categorized into altering the nail plate or diminishing periungual tissues. Conservative treatments alleviate early-stage symptoms, while surgical interventions are reserved for severe cases. Various surgical techniques are discussed, such as the Winograd technique, Vandenbos procedure, chemical matricectomy, radiofrequency ablation, bipolar diathermy, carbon dioxide laser ablation, Zadik's procedure, Howard-Dubois procedure, Super U procedure, Noël's procedure, knot technique, and toenail paronychium flap. The choice of procedure depends on the severity and recurrence of IGTN.

Does Electrocauterization of the Matrix After the Wedge Resection of the Toe-Nail Affect Recurrence in Discrete Age Groups Differently? A Retrospective Analysis

The onychocryptosis, also known as ingrown toe-nails, is a painful, common disorder which is less common in children than in adults. The purpose of the present study was to focus on the effect of electrocautery matricectomy on recurrence rate and clinical outcomes in different age groups. We performed a retrospective assessment of 189 consecutive ingrown toe-nails surgeries. Electrocautery matricectomy was performed in 68 (49.2%) of 138 (73%) adults, 25 (49%) of 51 (27%) adolescents. Recurrence was observed in 11 (21.5%) adolescent patients, while recurrence was observed in 12 (8.6%) adult patients. Recurrence was observed in 9 (9.6%) of 93 patients in whom cautery was used, while 14 (14.5%) recurrences were observed in 96 patients who did not use cautery. When the adolescent patient group was evaluated separately, recurrence was observed in 2 (8%) of 25 patients in the cautery group, while recurrence was observed in 9 (34.6%) of 26 patients in the other group. EM addition to the wedge excision does not affect the results in adult patients, but it significantly reduces recurrence in adolescent patients. Especially in younger patients, it is recommended to complete the matricectomy with electrocoagulation.

Comparison Of Winograde And Vandenbos Surgical Techniques According To Heifetz Stage In The Treatment Of Ingrown Toenails

Abstract Background: In ingrown toenail, classifications and the treatment approaches according to staging has been clearly reported in the literature. However, there are not enough data about the selection of the appropriate surgical technique according to the stage. In this study, we compared two different surgical techniques in patients with Heifetz stage 2 and 3 in means of surgical results, recovery time, patient comfort and cosmetics. Methods: Between January 2019 and January 21, patients who applied with the complaint of ingrown toenails who were treated with two mentioned surgical techniques in two centers with at least 1 year follow-up were included. The patients were evaluated preoperatively in means of the Heifetz classification. In group 1 (n:54) matrix excising Winograd and in group 2 (n:51) matrix preserving Vandenbos techniques were used. Postoperative recovery time, complication rates, functional and cosmetic patient satisfaction were evaluated in tall cases. Results: 105 cases of ingrown toenails treated surgically were included in the study. 62 (59%) cases were Heifetz stage 2, 43 (41%) cases were Heifetz stage 3. No statistically significant difference was found between Heifetz stage 2 and stage 3, regardless of surgical technique, in complication, recurrence, patient functional/cosmetic satisfaction rates, and recovery time. In overall analysis regardless of Heifetz staging, recovery time was shorter with Winograd method (p:0.0001), complication and recurrence rates were lower with Vandenbos method (p:0.0001), and VAS cosmetic satisfaction was higher in Vandenbos (p:0.002). Conclusion: Winograd and Vandenbos in Heifitz stages 2 and 3 have low complication rates and high patient satisfaction. Earlier healing could be achieved with the Winograd technique, while low complication/recurrence rates and high cosmetic satisfaction could be achieved with the Vandenbos technique. Early recovery/high cosmetic expectation should be considered instead of Heifetz staging in determining the surgical technique.