.: ORİJİNAL ARAŞTIRMA
A Comparison of the Chemical Matricectomy with Sodium Hydroxide and Winograd Method in the Operative Treatment of Ingrown Nail: A Case Control Study
Tırnak Batması Cerrahi Tedavisinde Sodyum Hidroksit ile Kimyasal Matrisektomi ve Winograd Yönteminin Karşılaştırılması: Bir Olgu Kontrol Çalışması
Turkiye Klinikleri J Dermatol. 2023;33(3):85-91
doi: 10.5336/dermato.2023-96968
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: There is no consensus on the operative method for ingrown nail treatment. The aim of this study was to compare the Winograd method and chemical matricectomy with sodium hydroxide in the treatment of ingrown big toenails. Material and Methods: 31 patients with chemical matricectomy with sodium hydroxide and 29 patients with the Winograd method were analyzed retrospectively. The two groups were compared in terms of intraoperative pain, the need for local anesthesia, patient satisfaction, Dermatology Life Quality Index, recurrence, and complication rates. Results: The mean intraoperative pain scores in groups chemical matricectomy and Winograd were 0.54±0.96 and 3.86±1.43, respectively (p=0.001). The recurrence rates were similar between the two groups (p=1.000). The number of satisfied and very satisfied patients at the last follow-up was respectively 31 (100%), in chemical matricectomy and 26 (89.65%) in Winograd group. The chemical matricectomy had a significantly rapid return time to school or work (day) (p<0.001). A statistically significantly negative correlation was found between preoperative Dermatological Quality of Life Index (DLQI) and post-operative satisfaction level (r=-0.312, p=0.024). Conclusion: Chemical matricectomy with sodium hydroxide and Winograd methods are both effective and reliable treatment methods in the treatment of ingrown toenails. Less intraoperative pain, the use of anesthetic agents, and rapid return time to school or work (day) may be an advantage of chemical matricectomy with sodium hydroxide. DLQI score before the procedures may give a clue for predicting satisfaction levels after ingrown nail procedures.
Keywords: Heifetz; ingrown toenail; matricectomy; sodium hydroxide; Winograd
Objective: There is no consensus on the operative method for ingrown nail treatment. The aim of this study was to compare the Winograd method and chemical matricectomy with sodium hydroxide in the treatment of ingrown big toenails. Material and Methods: 31 patients with chemical matricectomy with sodium hydroxide and 29 patients with the Winograd method were analyzed retrospectively. The two groups were compared in terms of intraoperative pain, the need for local anesthesia, patient satisfaction, Dermatology Life Quality Index, recurrence, and complication rates. Results: The mean intraoperative pain scores in groups chemical matricectomy and Winograd were 0.54±0.96 and 3.86±1.43, respectively (p=0.001). The recurrence rates were similar between the two groups (p=1.000). The number of satisfied and very satisfied patients at the last follow-up was respectively 31 (100%), in chemical matricectomy and 26 (89.65%) in Winograd group. The chemical matricectomy had a significantly rapid return time to school or work (day) (p<0.001). A statistically significantly negative correlation was found between preoperative Dermatological Quality of Life Index (DLQI) and post-operative satisfaction level (r=-0.312, p=0.024). Conclusion: Chemical matricectomy with sodium hydroxide and Winograd methods are both effective and reliable treatment methods in the treatment of ingrown toenails. Less intraoperative pain, the use of anesthetic agents, and rapid return time to school or work (day) may be an advantage of chemical matricectomy with sodium hydroxide. DLQI score before the procedures may give a clue for predicting satisfaction levels after ingrown nail procedures.
Keywords: Heifetz; ingrown toenail; matricectomy; sodium hydroxide; Winograd
ÖZET
Amaç: Tırnak batması tedavisinde ameliyat yöntemi konusunda fikir birliği yoktur. Bu çalışmanın amacı, tırnak batması tedavisinde Winograd yöntemi ve sodyum hidroksit ile kimyasal matrisektomiyi karşılaştırmaktır. Gereç ve Yöntemler: Sodyum hidroksit ile kimyasal matrisektomi yapılan 31 hasta ve Winograd yöntemi uygulanan 29 hasta retrospektif olarak incelendi. İki grup intraoperatif ağrı, lokal anestezi ihtiyacı, hasta memnuniyeti, Dermatolojik Yaşam Kalite İndeksi (DYKİ), nüks ve komplikasyon oranları açısından karşılaştırıldı. Bulgular: Kimyasal matrisektomi ve Winograd grubunda ortalama intraoperatif ağrı skorları sırasıyla 0,54±0,96 ve 3,86±1,43 idi (p=0,001). Nüks oranları iki grup arasında benzerdi (p=1,000). Son takipteki memnun ve çok memnun hasta sayısı sırasıyla kimyasal matrisektomide 31 (%100), Winograd grubunda 26 (%89,65) idi. Kimyasal matrisektominin okula veya işe dönüş süresi (gün) anlamlı derecede hızlıydı (p<0,01). Ameliyat öncesi DYKİ ile ameliyat sonrası memnuniyet düzeyi arasında istatistiksel olarak anlamlı negatif korelasyon bulundu (r=-0,312, p=0,024). Sonuç: Tırnak batması tedavisinde sodyum hidroksit ile kimyasal matrisektomi ve Winograd yöntemleri hem etkili hem de güvenilir tedavi yöntemleridir. Daha az intraoperatif ağrı, anestetik ajanların kullanımı ve hızlı okula veya işe dönüş süresi (gün) sodyum hidroksit ile kimyasal matrisektominin avantajları olabilir. İşlemlerden önceki DYKİ skoru, tırnak batması işlemlerinden sonraki memnuniyet düzeylerini tahmin etmede ipucu verebilir.
Anahtar Kelimeler: Heifetz; tırnak batması; matrisektomi; sodyum hidroksit; Winograd
Amaç: Tırnak batması tedavisinde ameliyat yöntemi konusunda fikir birliği yoktur. Bu çalışmanın amacı, tırnak batması tedavisinde Winograd yöntemi ve sodyum hidroksit ile kimyasal matrisektomiyi karşılaştırmaktır. Gereç ve Yöntemler: Sodyum hidroksit ile kimyasal matrisektomi yapılan 31 hasta ve Winograd yöntemi uygulanan 29 hasta retrospektif olarak incelendi. İki grup intraoperatif ağrı, lokal anestezi ihtiyacı, hasta memnuniyeti, Dermatolojik Yaşam Kalite İndeksi (DYKİ), nüks ve komplikasyon oranları açısından karşılaştırıldı. Bulgular: Kimyasal matrisektomi ve Winograd grubunda ortalama intraoperatif ağrı skorları sırasıyla 0,54±0,96 ve 3,86±1,43 idi (p=0,001). Nüks oranları iki grup arasında benzerdi (p=1,000). Son takipteki memnun ve çok memnun hasta sayısı sırasıyla kimyasal matrisektomide 31 (%100), Winograd grubunda 26 (%89,65) idi. Kimyasal matrisektominin okula veya işe dönüş süresi (gün) anlamlı derecede hızlıydı (p<0,01). Ameliyat öncesi DYKİ ile ameliyat sonrası memnuniyet düzeyi arasında istatistiksel olarak anlamlı negatif korelasyon bulundu (r=-0,312, p=0,024). Sonuç: Tırnak batması tedavisinde sodyum hidroksit ile kimyasal matrisektomi ve Winograd yöntemleri hem etkili hem de güvenilir tedavi yöntemleridir. Daha az intraoperatif ağrı, anestetik ajanların kullanımı ve hızlı okula veya işe dönüş süresi (gün) sodyum hidroksit ile kimyasal matrisektominin avantajları olabilir. İşlemlerden önceki DYKİ skoru, tırnak batması işlemlerinden sonraki memnuniyet düzeylerini tahmin etmede ipucu verebilir.
Anahtar Kelimeler: Heifetz; tırnak batması; matrisektomi; sodyum hidroksit; Winograd
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