Members do not see these Ads. Sign Up.

Hello,

I am just wondering whether anyone has ever had a case where phenol simply did not work and regrowth occurred repeatedly. Should a patient in that case be referred for sharp excision? or should the procedure be repeated with a longer exposure time to phenol, until it works?

Many thanks for any comments.

 

.........................................
Hi,

Just curious, how many % of the phenol do you normally use in your surgery? And how long do you phenolize the nail matrix?

 

80%, 3 minutes

 

Hi Jp
Yes, I have had two cases in my 3 decades of practice when repeated phenol procedures did not work.
I admit, I had to scratch my head and ended up doing Frost type procedures.

Other than these patients being super heros and thus possibly immune to the effects of phenol, I cannot explain this.

Steve

 

Hi Jp,
This will be my 23rd year in practice.
I've had 1 person who seemed to be resistant to liquid phenol. A healthy 17yo young lady. I remember her distinctly, as I could never work out why. Both hallux, both sulcus.
She ended up having a sharp resection procedure.

As for increasing the exposure time to phenol, I don't think this will make much difference. I remember speaking to a surgical colleague who felt that liquid phenol's performance diminished after about 30 secs. He was of the opinion that there was very little tissue destruction after this.

For the record, I do 3 applications with a minimum of 45secs each.

MF

 

many thanks for your replies.

I don't think there is some mysterious immunity though, as the procedure was successful on the patient's other hallux (the first time, that is).

I might just give it another try and then refer...
i hate when things happen that can't be explained :)

 

Have you used a torni-cot exsanguinating tourniquet. I would try 2-3 Phenol procedures then go to a Frost / Winograd.

 

yes I always do. thank you for your reply