The Effect of Removal of Granulation Tissue on Ingrown Toenails Associated with Granulation Tissue
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Onychocryptosis, commonly referred to as ingrown nails, has many therapeutic alternatives for its management. Although mild cases can be treated conservatively, in severe cases, surgical treatment is preferred. Silicone gel sheeting is found to be effective in the treatment of hypertrophic scars and keloids.To document the effectiveness of silicone gel sheeting in the management of patients with onychocryptosis and in the prevention of the recurrences by breaking the devil's circle, which usually took place after the surgical procedures used in the treatment of the onychocryptosis.Fourteen patients were enrolled in the study. Entry criteria required the presence of slight (2 patients), moderate (2 patients), or severe (10 patients) onychocryptosis. The simple technique used in the study was the excision of the one-quarter part of the lesional side of the nail plate without excising the granulation tissue. After 24 hours, the silicone was placed on the granulation tissue and the exposed nail bed. Silicone gel sheet was bandaged loosely without applying any pressure. Patients entering the study were given detailed instructions in applying and using the gel for 12 hours during the daytime. The study lasted for 14 months and was composed of a treatment period of 4 months and a follow-up period of 10 months. The patients were evaluated every 2 weeks in the first month and then monthly. The change in thickness of granulation tissue was evaluated by comparing them with the baseline photographs and those taken at each visit.The management and prevention of onychocryptosis were achieved in 12 of 14 patients (85.71%). The silicone gel sheeting treatment was well tolerated except for an occasional transient exudation, which was resolved when the treatment was withdrawn.The results show that the new method that we used for the treatment of onychocryptosis is successful in reducing the thickness of the hypertrophic nail fold and prevents the recurrence of the condition during the regrowth of the nail plate by breaking the devil's circle. The advantage of this method is that it is not destructive to the nail matrix and the adjacent tissue.
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Objective:To investigate the clinical therapeutic effects of two surgical methods for treating ingrown toenails paronychia.Methods:56 ingrown toenails paronychia patients were randomly divided into 2 groups,with 28 patients in each group.The patients in group A were treated by all nail extraction,while patients in group B were treated by partial nail extraction and partial nail bed extraction.The clinical therapeutic effects were observed after 3 months.Results:The healing time,frequency of dressing changes,cure rate and recurrence rate of patients in group B were all better than group A(P0.05).Conclusions:Partial nail extraction and partial nail bed extraction can get better effects for treating ingrown toenails paronychia than all nail extraction due to less pain,easy operation and low recurrence rate,so it is worth using in primary hospital.
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The treatment of ingrown toenail is usually bothersome for patients and doctors.To compare two treatment techniques of ingrown toenails-phenol matricectomy (PM) and nail-splinting using a flexible tube (FT)-in terms of efficacy, postoperative pain, postoperative cosmetic satisfaction, amount of tissue damage, and recurrence.One hundred twenty ingrown toenails were randomized and divided into PM and FT groups. All cases were evaluated 2 days and 1 and 6 months after treatment. Postoperative pain, cosmetic satisfaction, time to recovery, and recurrence rate were measured.Postoperative pain was less and cosmetic satisfaction was good in both groups (p <.001). Our recurrence rate was 8.4%. There were no statistical differences between groups in these measures. Tissue improvement rate was 6% in the PM group and 93% in the FT group 2 days after the procedures (p <.001).Although FT provides faster recovery and less postoperative morbidity than PM, the techniques are equally effective in treating ingrown toenails.
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Objective Sodium hydroxide matricectomy is a successful method for the treatment of ingrown toenails. This study was designed to evaluate the optimal sodium hydroxide application period providing high success rates with minimal postoperative morbidity. Materials and Methods Sixty-six patients with 225 ingrown nail edges were treated in three groups receiving 30-second, 1-minute, and 2-minute applications of sodium hydroxide. Each patient was reviewed postoperatively for pain, drainage, and tissue damage. The median long-term follow-up period was 14 months. Results The success rate of the therapy was 70.9% in the first group, 92.7% in the second group, and 94.4% in the third group. In all groups, about half of the patients experienced minimal pain within 48 hours following the operation, but only in the third group, 20% of the patients had minimal pain, which continued about 1 week. Drainage and tissue damage were minimal or mild in all groups and disappeared within 3 weeks in the first and second groups but were prolonged to 6 weeks in the third group. conclusion The success rate of 30-second application is significantly lower than 1-minute and 2-minute applications. Although the success rates of the latter two procedures are similar, the prolonged healing time is the disadvantage of the 2-minute application. We conclude that 1-minute application of 10% sodium hydroxide is simple, safe, and highly effective for the treatment of ingrown nails.
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Partial nail avulsion with lateral chemical matricectomy is the treatment of choice for ingrown toenails. Phenol (88%) is the most widely used chemical agent but prolonged postoperative drainage and collateral damage are common. Sodium hydroxide (NaOH) 10% has fewer side-effects.Adult, consenting patients with ingrown toenails were alternately allocated into two treatment groups in the order of their joining the study, to receive either 88% phenol (Group 1, n = 26) or 10% NaOH (Group 0, n = 23) chemical matricectomy. The patients as well as the statistician were blinded to the agent being used. Post-procedure follow-up evaluated median duration of pain, discharge, and healing along with recurrence, if any, in both the groups. The group wise data was statistically analyzed.Both the groups responded well to treatment with the median duration of postoperative pain being 7.92 days in Group 0 and 16.25 days in Group 1 (P < 0.202). Postoperative discharge continued for a median period of 15.42 days (Group 0) and 18.13 days (Group 1) (P < 0.203). The tissue condition normalized in 7.50 days (Group 0) and 15.63 days (Group 1) (P < 0.007).Limited postsurgical follow up of 6 months is a limitation of the study.Chemical matricectomy using NaOH is as efficacious as phenolisation, with the advantage of faster tissue normalization.
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Objective To explore the clinical effect of nail removal combined with clearing a small part of nail matrix in the treatment of paronychia. Methods 122 patients with paronychia visited doctors in clinic of our outpatient were randomly divided into the group A and the group B.The group A was treated by partial or complete nail removal simply, while in the group B,on the basis of therapy in group A,patients were additionally removed a small part of nail matrix in the affected side and using curette to scrape,and the residual part of a matrix with was removed by iodine tincture cautery. Results The recurrence rate of paronychia in the group A and group B was 55.73% and 4.92% respectively. Obviously,in the group B,the recurrence rate was lower than that in the group A(P0.05). Conclusion Nail removal combined with clearance of a small part of nail matrix has advantages of small wound,low recurrence rate,and it does not affect the appearance of the new beetle basically.It is worthy of promotion and application.
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Ingrown toenail is an often painful clinical condition that usually affects the big toe. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results. However, it produces extensive tissue destruction that can result in drainage and delayed healing. Alternatives such as sodium hydroxide and trichloroacetic acid (TCA) have therefore come into vogue. A total of 39 patients with 56 ingrown toenail edges underwent chemical matricectomy with 90% TCA after partial nail avulsion. In most of the patients, adverse effects such as postoperative pain and drainage were minimal. One patient who underwent matricectomy had recurrence in a single nail edge (1.8%) at 12 months follow-up. No recurrence was observed among 38 patients during the mean follow-up period. This was considered to be statistically significant (P < 0.001). Partial nail avulsion followed by TCA matricectomy is a safe, simple, and effective method with low rates of postoperative morbidity and high rates of success.
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Trichloroacetic acid
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Otorrhea and granulation tissue in Canal Wall Down mastoidectomy (CWD) is the common problem in cholesteatoma removal and leads to many discomfort for both the patient and the physician. The main objective in CWD is creating the dry cavity, so the topical antibiotic and acetic acid in variable saturations are used for this purpose. In this study we evaluate the effectiveness of topical MMC and chemical cautery by acetic acid.Study population consists of 50 patients with cholesteatoma whom underwent CWD. All patient allocated randomly in two study groups, MMC and acetic acid. After 3 weeks, the first visit is planned, extension of granulation tissue and dryness of cavity are evaluated and topical drugs are used in blind fashion. MMC in 4% and acetic acid in 12.5% saturation are applied. Other visits are completed at next month and 3 months later.Both methods are effective in treatment of granulation tissue. In each group both treatment were effective too but MMC was more effective than acid acetic in the treatment of granulation tissue after 4 weeks.Based on our findings, it is clear that topical MMC is very effective in the treatment of granulation tissue and in CWD. It results in dry cavity much better than acetic acid without any complication.
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Mastoidectomy
Granulation
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Objective To investigate the clinical effect of vacuum sealing drainage VSD)combined with skin graft treatment for deep burn wound infections. Methods 37 patients with deep burn trauma with infections were selected and divided them into control group(18 patients)and VSD group(19 patients)randomly.the control group received skin grafts pressure dressing therapy,while the observation group received VSD combined skin graft treatment.The wound healing rate,the granulation tissue colony count,time of debridement to terminal operation and the complication rate of the two groups were compared. Results In the control group,the 10 days wound healing rate were(49.6±8.2)%,the granulation tissue colony count were(3.5±0.2)×106,and the time of debridement to terminal operation were(25.3 ± 6.2)d.In the observation group,the 10 days wound healing rate were(72.5±13.4)%,the granulation tissue colony count were(5.9±1.1)×104,and the time of debridement to terminal operation were(14.1 ± 3.2)d.The 10 days wound healing rate,the granulation tissue colony count and the time of debridement to terminal operation in observation group had obvious difference compared to the control group(P0.05).The complications of severe infection,bleeding,tension blisters in observation group were lower than that in the control group. Conclusion VSD combined with skin graft treatment for deep burn wound infection has satisfactory clinical effect.It could effectively promote the wound healing,reduce the bacterial colony count and the complication rate.
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Debridement (dental)
Bacterial colony
Clinical efficacy
Blisters
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