TY - JOUR T1 - Soft-tissue nail-fold excision: a definitive treatment for ingrown toenails JF - Canadian Journal of Surgery JO - CAN J SURG SP - 282 LP - 286 VL - 53 IS - 4 AU - Henry Chapeskie AU - Jason R. Kovac Y1 - 2010/08/01 UR - http://canjsurg.ca/content/53/4/282.abstract N2 - Background: Ingrown toenail, or onychocryptosis, is a common source of morbidity worldwide. The current standard of care focuses on the nail as the causative agent, and, in cases that are resistant to medical management, surgical correction via nail avulsion and phenol matrix ablation is used. Unfortunately, this treatment leads to poor cosmetic results, high rates of recurrence and low patient satisfaction.Methods: We retrospectively reviewed a case series of 124 consecutive patients who underwent surgical correction of ingrown toenails from 1988 to 2004. We recorded the operative technique and postoperative wound healing via photographs. We assessed outcomes and patient satisfaction using self-reports and 7-point Likert scale questionnaires.Results: Our surgical approach involved the excision of excessive nail-fold granulation tissue with preservation of the nail and its matrix. In total, 72.5% of patients were under the age of 29 (69.4% men). Before surgical intervention, 78.8% of patients scored their pain as severe, 69.9% had difficulty wearing normal footwear and 64.3% had difficulty with normal activities because of their ingrown toenails. A total of 212 surgical sites were analyzed, with a median follow-up of 8 years. No recurrences were identified in any patients (100%, n = 124). Overall, 94.3% (n = 116) stated that they were highly satisfied with the procedure. Only 1.6% (n = 2) reported a loss of sensation at the surgical site.Conclusion: Surgical correction of ingrown toenails via soft-tissue excision of the nail folds, coupled with preservation of the nail and its matrix, had excellent cosmetic results, no recurrences and high rates of patient satisfaction. ER -