Muriel-Sánchez Juan Manuel, Becerro-de-Bengoa-Vallejo Ricardo, Montaño-Jiménez Pedro, Coheña-Jiménez Manuel
Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain.
Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain.
J Clin Med. 2020 Mar 20;9(3):845. doi: 10.3390/jcm9030845.
In onychocryptosis surgery, incisional and non-incisional matricectomy is indicated according to the stage. The chemical matricectomy with 88% phenol solution is the gold standard and a wedge resection is indicated for more advanced stages. The aesthetic reconstruction has the advantages of the incisional procedure without eponychium incisions and an effectiveness similar to the chemical matricectomy with phenol.
To compare the recurrence and the healing time between the chemical matricectomy with phenol and the aesthetic reconstruction.
A comparative, prospective, parallel, randomized, and one-blinded clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2019-001294-80. Thrity-four patients (56 feet) with 112 onychocryptosis were randomized in two groups. Thirty-six were treated with chemical matricectomy with phenol and 76 with aesthetic reconstruction. Each patient was blind to the surgical procedure assigned by the investigator. The primary outcome measurements were healing time and recurrence. The secondary outcome measurements were post-surgical bleeding, pain, inflammation, and infection rate.
The aesthetic reconstruction procedure presents a shorter healing time (8.2 ± 1.4 days vs. 21.3 ± 3.1 days; < 0.001) with a similar recurrence rate ( = 0.98). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences ( > 0.05).
The aesthetic reconstruction presents a shorter healing time, favoring the patients' recuperation, with a recurrence similar to the chemical matricectomy with 88% phenol solution.
在嵌甲手术中，根据分期选择切开和非切开甲床切除术。88%苯酚溶液化学性甲床切除术是金标准，对于更晚期病例则采用楔形切除术。美学重建术具有切开手术的优点，无需切开甲上皮，且效果与苯酚化学性甲床切除术相似。
比较苯酚化学性甲床切除术与美学重建术的复发率和愈合时间。
一项对比、前瞻性、平行、随机、单盲临床试验已在欧洲临床试验数据库（EudraCT）注册，识别号为2019 - 001294 - 80。34例（56足）患有112处嵌甲的患者被随机分为两组。36例接受苯酚化学性甲床切除术，76例接受美学重建术。每位患者对研究者分配的手术方式不知情。主要观察指标为愈合时间和复发率。次要观察指标为术后出血、疼痛、炎症和感染率。
美学重建术的愈合时间更短（8.2±1.4天对21.3±3.1天；<0.001），复发率相似（=0.98）。术后出血、疼痛、炎症和感染率无显著差异（>0.05）。
美学重建术愈合时间更短，有利于患者康复，复发率与88%苯酚溶液化学性甲床切除术相似。
