J Am Podiatr Med Assoc. 2020 Jul 1;110(4). doi: 10.7547/17-199.
The objective of this study was to evaluate the effectiveness of the surgical method of arc resection of soft-tissue nail fold combined with a shaped dressing for ingrown toenails. The surgical method involved the excision of nail fold granulation tissue and partial or total nail avulsion with preservation of its matrix. This surgical approach was applied to 20 consecutive patients (age range, 11-30 years) admitted to the hospital from January 1, 2014, to December 31, 2015. For assessment of the method, the operative technique, dressing change, and postoperative wound healing were recorded by photography. Finally, we evaluated the therapeutic effects by calculating the recurrence rate and nail groove expansion rate. Twenty patients with 38 surgical sites in 26 toes were analyzed; there was no recurrence at 3, 6, and 12 months. There was a statistically significant difference in the groove expansion rate at different time points. We measured the wound distance on postoperative day 1 compared with the day of healing and found that the method of shaped dressing could expand the nail groove by more than 50% (P ≤ .05). The mean ± SD recovery time was 15.1 ± 2.4 days. Arc resection of the nail folds for ingrown toenails coupled with preservation of its matrix minimizes trauma and is easy to manipulate. Applying a shaped dressing after the operation further reduces the risk of recurrence and ensures enough growth space for the toenails.
本研究旨在评估软组织甲襞弧形切除术联合塑形敷料治疗嵌甲的有效性。手术方法包括切除甲襞肉芽组织和部分或全部拔甲,同时保留甲母质。2014 年 1 月 1 日至 2015 年 12 月 31 日,我们连续收治 20 例(年龄 11-30 岁)嵌甲患者,采用该术式治疗。通过拍照记录手术技术、敷料更换和术后伤口愈合情况,评估手术方法。最后,通过计算复发率和甲槽扩张率来评估疗效。26 个脚趾的 38 个手术部位的 20 例患者纳入分析,术后 3、6、12 个月均无复发。不同时间点甲槽扩张率有统计学差异。我们测量了术后第 1 天和愈合时的伤口距离,发现塑形敷料的方法可以使甲槽扩张超过 50%(P≤.05)。平均恢复时间为 15.1±2.4 天。弧形切除嵌甲的甲襞并保留其甲母质可最大程度地减少创伤,操作简单。术后应用塑形敷料可进一步降低复发风险,为趾甲提供足够的生长空间。