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二氧化碳激光手术治疗嵌甲时侧褶汽化与不汽化的比较。

A comparison between CO2 laser surgery with and without lateral fold vaporization for ingrowing toenails.

作者信息

Orenstein Arie, Goldan Oren, Weissman Oren, Tamir Jeremy, Winkler Eyal, Klatzkin Shmuel, Haik Josef

机构信息

Department of Plastic & Reconstructive Surgery, Sheba Medical Center, Tel-Hashomer affiliated to Sackler School of Medicine, Tel-Aviv University, Israel.

出版信息

J Cosmet Laser Ther. 2007 Jun;9(2):97-100. doi: 10.1080/14764170701275149.

Abstract

BACKGROUND

An ingrowing toenail is an excessive lateral nail growth into the nail fold. It acts as a foreign body and exerts a local pressure sore-like effect, which may result in inflammation and granulation. Several treatment modalities exist, including chemical ablation and different surgical procedures. Here we describe and compare a simple and effective method of partial matricectomy using the CO2 laser (group A) versus a similar method with the addition of lateral nail fold vaporization (group B).

OBJECTIVE

Outcome evaluation of a modified laser treatment modality for ingrowing toenails and determination of the role of lateral fold vaporization in reducing the recurrence of symptoms.

METHODS

Forty patients (mean age 32.45 years) were treated with CO2 laser ablation of toenails between 1999 and 2005 by four physicians. One physician implemented a method that includes lateral nail fold vaporization and resection of the nail segment with its nail bed from 1999 to 2005. Three physicians implemented a similar technique but without lateral fold vaporization between 1999 and 2003, and added lateral fold vaporization to the performed procedure starting in 2004.

RESULTS

The recurrence rate was 37.5% in group A and 6.2% in group B. The overall average disease-free follow-up period was 42.2 months.

CONCLUSION

The use of CO2 laser in the treatment of ingrowing toenails offers an effective modality. We demonstrate the importance of lateral fold vaporization with the CO2 laser both in improving efficacy and in decreasing recurrence rates over a long follow-up period.

摘要

背景

嵌甲是指甲过度向甲沟侧方生长。它如同异物,产生类似局部压疮的效应,可能导致炎症和肉芽组织形成。现有多种治疗方式,包括化学消融和不同的外科手术。在此,我们描述并比较一种使用二氧化碳激光的简单有效部分甲床切除术方法(A组)与一种类似方法并附加甲沟汽化术(B组)。

目的

评估一种改良的激光治疗嵌甲方式的疗效,并确定甲沟汽化术在降低症状复发率方面的作用。

方法

1999年至2005年期间,四位医生用二氧化碳激光消融术治疗了40例患者(平均年龄32.45岁)。一位医生在1999年至2005年实施了一种包括甲沟汽化术以及切除指甲及其甲床部分的方法。三位医生在1999年至2003年实施了类似技术但未进行甲沟汽化术,从2004年起在实施的手术中增加了甲沟汽化术。

结果

A组复发率为37.5%,B组为6.2%。总体平均无病随访期为42.2个月。

结论

使用二氧化碳激光治疗嵌甲提供了一种有效的方式。我们证明了在长期随访中,二氧化碳激光甲沟汽化术在提高疗效和降低复发率方面的重要性。

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