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I am struggeling with finding evidence or guidelines on when or whether fibrous nailbed tissue (for example in mycotic nails) needs to be removed prior to phenolisation following the removal of the nail. Would leaving fibrous tissue affect the phenol effectiveness leading to risk of regrowth. Anyone can direct me on where I can find the info? I have had conflicting information from colleagues.

Thank you.

 

I'm not entirely sure what you mean by 'fibrous tissue' in these instances. However, if you are suggesting doing an incisional technique and then using phenol, please be aware that there are cases on record (don't have the references to hand) in which aesepic necrosis of the distal phalanx has occurred and resulted in amputation of the toe(s). Why not simply carry out a Zadeks/Winograd/Frost?

Bill Liggins

 

How does it effect the phenol application as the nail grows from the matrices? Maybe you could elaborate a little more.