Batan Ayak Tırnağı Tedavisinde Matrisektomi ve Elektro-koterizasyonun Geriye Dönük Karşılaştırması

Amaç: Batık ayak tırnakları yaygın bir sağlık problemi olmasına rağmen, standart birinci seçenek tedavi konusunda fikir birliği yoktur. Batık ayak tırnakları için farklı cerrahi olmayan ve cerrahi müdahaleler mevcuttur. Amacımız batık ayak tırnaklarında iki cerrahi tedavi yöntemini karşılaştırmaktı; elektro-koterizasyonlu matriktomi (ME) ve cerrahi matriktomi (SM). Gereç ve Yöntem: Ayak tırnağı batmış toplam 111 hasta randomize olarak iki gruba ayrıldı: cerrahi matrisektomi ve elektro-koterizasyonlu matrisektomi. Tüm olgular tedaviden 1 gün, 1 hafta, 3 ve 6 ay sonra değerlendirildi. Nüks oranları, görsel analog skala (VAS) skorları karşılaştırıldı. Bulgular: ME grubunda postoperatif 1. gün ortalama VAS skoru SM grubundan daha yüksekti (1.94'e karşı 0.93), ancak 8. gün VAS skorlarında fark yoktu. Ortalama nüks oranı ME grubunda SM grubuna göre daha yüksekti (% 33.9'a karşı% 1.7). Sonuç: SM, batık ayak tırnağının tedavisinde postoperatif ağrı ve nüks açısından ME yöntemine göre daha etkili bir yöntemdir.

Anahtar Kelimeler:

Tırnak batması, Matrisektomi, Tedavi

Retrospective Comparison of Matricectomy and Electrocauterization in the Treatment of Ingrown Toenail

Objective: Although ingrown toenails are a common health problem, there is no consensus about a standard first-choice treatment. Different non-surgical and surgical interventions for ingrown toenails are available. Our aim was to compare two surgical treatment methods for ingrown toenails; matricectomy with electrocauterization (ME) and surgical matricectomy (SM). Materials and Methods: A total of 111 patients with ingrown toenail were randomized into two groups: surgical matricectomy and matricectomy with electrocauterization. All cases were evaluated 1 day, 1 week, 3 and 6 months after treatment. Recurrence rates, visual analog scale (VAS) scores were compared. Results: Postoperative 1st day mean VAS score in ME group was higher than SM group (1.94 vs 0.93), but there was no difference in 8th day VAS scores. The mean recurrence rate was higher in ME group compared to SM group (33.9% vs 1.7%). Conclusions: SM is more effective method compared to ME method in terms of postoperative pain and recurrence in the treatment of ingrown toenail.

Keywords:

Matricectomy, Ingrown toenail, Treatment,

PDF

___

1. Barreiros H, Matos D, Goula~o J, Serrano P, Joa~o A, Branda~o FM. Using 80% tri- chloroacetic acid in the treatment of ingrown toenails. An Bras Dermatol 88:889– 893, 2013.
2. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician 79:303–308, 2009.
3. Karaca N, Dereli T. Treatment of ingrown toenail with proximolateral matrix partial excision and matrix phenolization. Ann Fam Med 10:556–559, 2012.
4. Korkmaz M, Co€lgec ̧ en E, Erdog!an Y, Bal A, Ozyurt K. Teenage patients with ingrown toenails: treatment with partial matrix excision or segmental phenolization. In- dian J Dermatol 58:327, 2013.
5. Richardson EG, Hendrix CL. Disorders of nail and skin. In: Canale ST, editors. Campbell’s Operative Orthopaedics. Philadelphia : Mosby; 2003. p. 4171-87.
6. Foulston J. Ingrown toe nail. In : Helal B, Wilson D, editors. The foot. New York: Churchill Livingstone; 1988. p. 858-867.
7. Bostancı S, Ekmekçi P, Gürgey E. Chemical matricectomy with phenol for the treatment of ingrown toenail: A review of the literature and follow- up of 172 treated patients. Acta Derm Venereol 2001; 81:181-3.
8. Laco JE. Nail Surgery. In : Vincent J Hetherington, editors. Textbook of hallux valgus and forefoot surgery. New York: Churchill Livingstone; 2000 p. 481-497.
9. Cameron PF. Ingrown toenails: An evaluation of two treatments. Br Med J 1981;283:821-2.
10. Wollina U. Modified Emmet’s operation for ingrown nails using the Er:YAG laser. J Cosmet Laser Ther 2004;6:38-40.
11. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician 2009;79:303-308.
12. Haneke E. Controversies in the treatment of ingrown nails. Dermatol Res Pract 2012:783924, 2012.
13. Khunger N, Kandhari R. Ingrown toenails. Indian J Dermatol Venereol Leprol 78:279–289, 2012.
14. Grieg JD, Anderson JH, Ireland AJ, Anderson JR. The surgical treatment of ingrown toenails. J Bone Joint Surg Br 1991;73:131–3.
15. Palmer BV, Jones A. Ingrown toenails: the results of treatment. Br J Surg 1979;66:575–6.
16. Zaraa I, Dorbani I, Hawilo A, Mokni M, Ben Osman A. Segmental phenolization for the treatment of ingrown toenails: technique report, follow up of 146 patients, and review of the literature. Dermatol Online J 19:18560, 2013.
17. Talwar A, Puri N. A study on the surgical treatment of ingrowing toe nail with nail excision with chemical matricectomy versus nail excision alone. Our Dermatol Online 4:32–34, 2013.
18. Kayalar M, Bal E, Toros T, Ozaksar K, Gu€rbu€z Y, Ademog!lu Y. Results of partial matrixectomy for chronic ingrown toenail. Foot Ankle Int 32:888–895, 2011.
19. Eekhof JA, Van Wijk B, Knuistingh Neven A, van der Wouden JC. Interventions for ingrowing toenails. Cochrane Database Syst Rev 4:CD001541, 2012.
20. Tweede JH, Ranger I. A simple procedure with nail preservation for ingrown toe-nails. Arch Emerg Med 1985;23:149-54.
21. Herold N, Houshian S, Riegels-Nielsen P. Prospective comparison of wedge matrix resection with nail matrix phenolization for the treatment of ingrown toenail. J Foot Ankle Surg 2001;40:390-5.
22. Richardson EG, Hendrix CL. Disorders of nail and skin. In: Canale ST, editors. Campbell’s Operative Orthopaedics. Philadelphia : Mosby; 2003. p. 4171-87.
23. Murray WR, Bedi BS. The surgical management of ingrowing toenail. Br J Surg 1975;62:409-12.
24. Kruijff S, van Det RJ, van dre Meer GT, van den Berg IC, et al. Partial matrix excision or orthonyxia for ingrowing toenails. J Am Coll Surg 2008;206:148-53.
25. Rounding C, Bloomfield S. Surgical treatments for ingrowing toenails. Cochrane Database Syst Rev 2005;2:CD001541.
26. Yang KC, Li YT. Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricecetomy with a Sharpulse carbon dioxide laser. Dermatol Surg 2002;28:419-21.
27. Aksakal AB, Akar A, Erbil H, Onder M. A new surgical therapeutic approach to pincer nail deformity. Dermatol Surg 2001;27:55-7.
28. Ozdemir E, Bostanci S, Ekmekci P, Gurgey E. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowning toenails. Dermatol Surg 2004;30:26-31.
29. Lin YC, Su HY. A surgical approach to ingrown nail: partial matricectomy using CO2 laser. Dermatol Surg 2002;28:578-80.
30. Leshin B, Whitaker DC. Carbon dioxide laser matricectomy. J Dermatol Surg Oncol 1988;14:608-11.
31. Serour F. Recurrent ingrown big toenails are efficiently treated by CO2 laser. Dermatol Surg 2002;28:509-12.
32. Takahashi M, Narisawa Y. Radical surgery for ingrown nails by partial resection of the nail plate and matrix using a carbon dioxide laser. J Cutan Laser Ther 2000;2:21-5.