Postoperative treatment after partial nail ablation of ingrown toenails

NewsBot · May 8, 2019

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Postoperative treatment after partial nail ablation of ingrown toenails — does it matter what we recommend? A blinded randomised study
S. V. Bernardshaw, Liv Helene Dolva Sagedal, Kristin Møystad Michelet & Christina Brudvik
Scandinavian Journal of Primary Health Care : 03 May 2019

Trial design: In this blinded randomized study we analyzed patient reported outcome of three different treatments after nail surgery. We compared daily footbath with either alkaline or acidic soap or just a simple bandage of gauze dressing.

Method: After partial nail ablation surgery, patients were randomized into three postoperative treatment modalities. Outcome in terms of reduction in pain, improvement of function, reduction of signs of infection and postoperative soothing effect were reported after one and two weeks. A generalized linear mixed model was used to analyze possible statistical differences between the groups.

Results: 97 patients, 57% women, mean age 31 years, were included. Men reported significantly less pain and better function than women. Despite a registered lower growth of invasive pathogenic microbes following the use of acidic soaps, this did not lead to less infections than in the groups using either alkaline soap baths or bandaging. On the contrary, patients keeping the bandage on had significantly lower signs of infection after one week. Two patients using soap baths had growth of MRSA. Two weeks postoperatively, all three treatment alternatives had similar patient reported outcome in all parameters, and nobody needed antibiotics.

Conclusions: This prospective randomized study was unable to prove that footbath with either acidic or alkaline soap should be preferred to just leave the postoperative bandage on for a week after partial nail ablation. We recommend that postoperative advice should be given on an individual basis, especially since our study did not involve patients with high risk of infections.
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William Fowler · May 8, 2019

"This prospective randomized study was unable to prove that footbath with either acidic or alkaline soap should be preferred to just leave the postoperative bandage on for a week "

Really?

NewsBot · Oct 2, 2019

Effectiveness of Leukocyte and Platelet-Rich Fibrin
versus Nitrofurazone on Nail Post-Surgery Bleeding
and Wound Cicatrization Period Reductions:
A Randomized Single Blinded Clinical Trial
Xavier Garrido-Castells et al
J. Clin. Med. 2019, 8, 1552; doi:10.3390/jcm8101552

Background: Leukocyte and platelet-rich fibrin (L-PRF) may be considered a co-adjuvant
intervention that may play a key role in blood coagulation and tissue repair after nail surgeries.
The aim of this study was to determine the effectiveness of L-PRF versus nitrofurazone on the
post-surgical bleeding and wound cicatrization period in patients with bilateral onychocryptosis
during surgeries of chemical matrixectomies with 88% phenol solution. Methods: A randomized
single-blind clinical trial was registered with the European Clinical Trials Database (EudraCT) with
identification number 2016-002048-18. Twenty healthy participants with bilateral onychocryptosis
(n = 40) were recruited and bilaterally received both protocols for both halluces. Patients with a
mean age mean of 45.55 ± 12.19 years attended a specialized foot and ankle surgery clinic. Both
halluces of each patient were randomized and allocated to receive L-PRF (experimental group; n = 20
halluces) or nitrofurazone (control group; n = 20 halluces) interventions in conjunction with surgery
of chemical matrixectomies with 88% phenol solution for bilateral ingrown of toenail border (medial
and lateral). Patients were blinded to their intervention in each hallux. The primary outcome
measurement was post-surgical bleeding. The secondary outcome measurements were post-surgical
pain intensity, inflammation, infection, analgesic intake, and wound cicatrization period. Results:
Statistically significant differences (p < 0.001) were found between both groups showing a reduction
for wound cicatrization period and post-surgical bleeding for the L-PRF intervention with respect
to nitrofurazone treatment. The rest of the outcome measurements did not show any statistically
significant differences (p > 0.05). Conclusions: L-PRF rather than nitrofurazone in conjunction with
chemical matrixectomies performed with 88% phenol solution reduced the wound cicatrization period
and bleeding after nail surgery. Thus, L-PRF may be considered a first-line co-adjuvant intervention
for patients who suffer from nail problems, such as onychocryptosis, that require surgical procedures.
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NewsBot · Aug 15, 2022

Management of post-surgical infection of onychocryptosis with topical application of hyaluronic acid versus antibacterial ointments
Almudena NúñezFernándezAlvaroGómez-CarriónIgnacioZaragoza-GarcíaCarlos MartínezSebastiánPaola SanzWozniakArturo GómezLaraAlvaro SauraSempereRubénSánchez-Gómez
Source

Highlights
•It is unclear what is the best AO to treat and/or prevent wound infections following ingrown toenail surgery.
•The purpose of the present study was to review the main AO currently used to prevent or treat postoperative skin infections and to compare these with HA to establish which would be the best option.
•HA has great anti-inflammatory capacities, the ability to create a stable environment for the healing of ulcers and wounds, it provides hydration, elasticity, and firmness to the skin.
•The HA combined with antibiotics, specifically SS, is a very good option for partial burns.
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Introduction
The prevention and cure of postoperative infections has been a source of study over the years and is currently being studied. In this bibliographic review, a comparison between the different products used for the prevention and treatment of postsurgical infections has been procured, likewise, being able to determine which would be the best option for the treatment of post-surgical infections. In this bibliographic review we focus on Onychocryptosis because it is an emerging problem today. Many surgeries are performed to fix this condition, which increases the risk of infections.

Material
databases, including PubMed and Cochrane Library, as well as websites of international organizations, were searched up to January 2021. The search included studies and trials in humans on the use of hyaluronic acid and antibacterial ointments in various conditions or diseases.

Results
18 articles were analyzed individually, which included randomized studies of Hyaluronic Acid, various antibiotics and honey, and variables used topically. 3 articles were also selected to explain onychocryptosis and postoperative infections.

Conclusion
Despite being able to determine which antibiotic would be the best, and whether hyaluronic acid can be used for the prevention and/or cure of post-surgical infections, this review emphasizes that there is still a need for more specific studies on its use of these variables, both in post-surgical infections in general and in post-surgical onychocryptosis infections
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