Islam Saleem, Lin Erin McKean, Drongowski Robert, Teitelbaum Daniel H, Coran Arnold G, Geiger James D, Hirschl Ronald B
CS Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA.
J Pediatr Surg. 2005 Jan;40(1):290-2. doi: 10.1016/j.jpedsurg.2004.09.051.
Ingrown toenails in children are a common problem with a high recurrence rate. The objective of this retrospective data review was to compare simple excision of the nail matrix with excision plus phenol (EPP) application in the treatment of ingrown toenails.
The charts of 69 children who underwent surgical treatment of one or more ingrown toenails from 1994 to 2000 were reviewed. The primary procedure was noted (excision alone [EA] vs EPP) and dates of recurrences and reoperations were recorded. Parents were then surveyed by phone regarding complications, cosmetic outcome, and overall satisfaction with the procedure. Five scale categories, ranging from "strongly agree" to "strongly disagree", were used, with responses of "strongly agree" and "agree" considered as a good outcome. Either Student's t test or the chi2 test (P < .05 considered significant) was used for analysis.
Thirty-one patients (45%) were in the EPP group whereas the remaining 38 had EA. Mean length of follow-up was 4.3 years for the EA group and 2.1 years for the EPP group. There was no difference in age at operation or length of follow-up between the 2 groups. Boys were predominant in both groups. The survey response rate was 50/69 (73%). The recurrence rate of ingrown toenails in the EA group was 42% vs 4% in the EPP group (P = .003). There were no significant differences in parental response with regard to operative experience (P = .31) and the cosmetic result (P = .13), with most of the respondents (78%) indicating a good outcome for both questions.
The addition of phenol to the surgical excision of ingrown toenail significantly reduced the incidence of recurrence, with similar patient satisfaction and an equivalent cosmetic result.
儿童嵌甲是一个常见问题，复发率很高。本回顾性数据研究的目的是比较单纯切除甲床与切除加用苯酚（EPP）治疗嵌甲的效果。
回顾了1994年至2000年期间接受一个或多个嵌甲手术治疗的69名儿童的病历。记录主要手术方式（单纯切除[EA]与EPP）以及复发和再次手术的日期。随后通过电话对家长进行调查，了解并发症、美容效果以及对手术的总体满意度。采用从“强烈同意”到“强烈不同意”的五个等级类别，“强烈同意”和“同意”的回答被视为良好结果。分析采用Student's t检验或chi2检验（P < 0.05认为有统计学意义）。
31名患者（45%）在EPP组，其余患者38名接受EA手术。EA组的平均随访时间为4.3年，EPP组为2.1年。两组患者的手术年龄或随访时间无差异。两组均以男孩为主。调查回复率为50/69（73%）。EA组嵌甲复发率为42%，而EPP组为4%（P = 0.003）。家长对手术体验（P = 0.31）和美容效果（P = 0.13）的反馈无显著差异，大多数受访者（78%）对这两个问题均表示良好结果。
在嵌甲手术切除中加用苯酚可显著降低复发率，患者满意度相似，美容效果相当。
