BACKGROUND: The use of antibiotics (ABs) for the prevention and management of infections has been widespread for decades and, at this time, AB resistance is a global health crisis. The available evidence highlights the need to reduce the prophylactic and therapeutic use of ABs to avoid associated risks.
METHODS: A preliminary study with a total sample of 56 Andalusian (Spain) podiatrists was surveyed. The purpose of this study was to identify whether there were changes in prescription habits from a situation before a subsequent training course on AB indications for the management of infections associated with ingrown toenails. An ad hoc questionnaire of 15 items related to therapeutic and prophylactic prescriptions of ABs was developed for this purpose, and the evaluation was carried out before and after the training course.
RESULTS: The responses obtained before and after training were compared. The training activity led to improvements in the prescription habits of the participants, producing significant changes in the prescription pattern of the professionals in 10 of the 15 items.
CONCLUSIONS: The results of this preliminary study show that the podiatrists surveyed improved the rational use of systemic AB therapy in ingrown toenails infections.

暂无摘要。

BACKGROUND: Cryotherapy reduces pain by making some reversible functional changes in peripheral nerves. It has also been reported to have a positive effect on the regression of inflammation and granulation tissue. Few studies have evaluated the efficacy and safety of nail fold cryotherapy in ingrown toenails (IGTN) in adults, and there are no studies in the pediatric population. We aimed to evaluate the clinical efficacy of cryotherapy applied to the nail fold in juvenile IGTN.
METHODS: This study was conducted in adolescent patients aged 12 to 16 years with unilateral juvenile IGTN. Liquid nitrogen was sprayed into the nail fold for 10 to 15 seconds with a double freeze-thaw cycle. The effectiveness of cryotherapy was interpreted by the clinician\'s decision, the improvement in visual analogue scale score, Children\'s Dermatology Life Quality Index score, and granulation tissue.
RESULTS: According to the physician, good efficacy was achieved in 91.7% of patients (n = 22 of 24). We found that 54.5% of them (n = 12 of 22) were still in remission after 6 months. Rates of complete regression in granulation tissue were pronouncedly less in sizes larger than 5 mm (≤5 mm, 55.6%; >5 mm, 16.7%). However, adequate symptomatic relief was observed in 83.3% of stage 3 patients, even if complete granulation tissue response was not achieved yet. Significant improvements in visual analogue scale and the Children\'s Dermatology Life Quality Index scores were observed after cryotherapy (P < .05).
CONCLUSIONS: Nail fold cryotherapy is a useful alternative among conservative methods because of its rapid and high efficiency (91.7%), especially in mild to moderate cases, despite the high recurrence rates (45.5%) in juvenile IGTN.

Treatment of ingrown toenail includes various nonsurgical and surgical treatments. However, there is no consensus on the ideal first-choice treatment.
To compare phenolization versus surgical matricectomy (SM) after lateral nail plate avulsion in terms of efficacy, recurrence rates, postoperative outcomes, and cosmesis.
The authors enrolled 45 consenting patients and randomized them into 2 groups (Group 1 = phenolization and Group 2 = SM) using stratified block randomization and followed them up at 1 week, 1 month, and 6 months.
The median percentage improvement in pain visual analog scale (VAS) score was comparable between the 2 groups ( p = 0.793). The mean photo VAS showed significant improvement in Group 1 at 1 week ( p = 0.00) and 1 month ( p = 0.02) but not at 6 months ( p = 0.44). The median number of days for pain relief ( p = 0.169), for healing ( p = 0.192), and for resuming work ( p = 0.136) were not significantly different between the 2 groups. The time required to regain normal morphology was significantly longer in Group 2 ( p = 0.006). None of the patients in either group presented with recurrence at 6 months and 1 year. The authors observed failure of treatment in 1 patient in Group 2.
Both procedures were equally efficacious, had minimal complications, and showed no recurrence at 6 months and 1 year.

BACKGROUND: Post-operative cures with hyaluronic acid (HA) could potentially shorten the period recovery involved in the phenol technique for ingrown toenail. The aim of this study was therefore to compare a standard healing protocol with the experimental one based on hyaluronic acid cream.
METHODS: 70 patients who had undergone phenol technique surgery for ingrown toenail were divided into two groups - control (n = 35) who received post-operative cures following the standard protocol with povidone iodine gel, and experimental (n = 35) who received cures with HA in the first 3 visits. Bleeding, total healing time, and perceived pain were assessed.
RESULTS: Patients in the control group recovered from the intervention in a total of 26.17 ± 7.75 days, while those in the HA group recovered in a significantly shorter time - 22.42 ± 2.41 days (p = 0.007, effect size 0.653). However, there were no between-group statistical differences in bleeding or perceived pain over the course of the post-surgery visits.
CONCLUSIONS: The use of low molecular weight hyaluronic acid is effective in reducing the phenol-technique healing time by 4 days compared with the standard cure. However, no extra effects such as reductions in bleeding or perceived pain can be expected in choosing this healing protocol.

暂无摘要。

BACKGROUND: Although partial onychectomy with chemical matricectomy has been described asthe treatment of choice, there is sparse evidence in the literature regarding the use of silvernitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrixcauterization after partial onychectomy.
METHODS: A prospective observational study was performed on patients with ingrown toenailsstage 2-3 who underwent partial onychectomy with silver nitrate chemical matricectomy during 2018-2019 in our institution. All patients were evaluated in the outpatient clinic on the 7th and 30th post-operative day and a telephone evaluation was performed every 6 months afterthe surgical procedure to date.
RESULTS: One hundred and twenty-three patients, who underwent 231 partial onychectomies with silver nitrate chemical matricectomy were included, with a median follow-up of 21 months (interquartile range, 12-29). The procedure had an effectiveness of 95.3%, with only 11 recur-rences (4.7%) reported so far on follow-up. Postoperative infections were observed in 4 patients (1.7%). Adverse effects, such as pain and postoperative drainage, were irrelevant in mostpatients.
CONCLUSIONS: Silver nitrate matricectomy after partial onychectomy is an effective and safealternative for the treatment of ingrown toenail in children, with scarce postoperative morbidityand low recurrence rate.

BACKGROUND: Partial onychectomy with chemical matrixectomy is considered the gold standard treatment for stage II-III ingrown toenails (IT). However, there are scarce reports describing the use of silver nitrate in IT management in adolescents. Our aim is to analyze the effectiveness of matrix ablation with silver nitrate and compare it with partial onychectomy by electrocautery.
METHODS: A retrospective study of adolescent patients with stage II-III IT was performed. Those who underwent electrocautery matricectomy in a major outpatient surgical center (Group A) and those who were treated with silver nitrate at an outpatient clinic (Group B) were compared. Efficacy was determined by recurrence and postoperative infection rates.
RESULTS: Two hundred and nine patients were included (86 group A; 123 group B), with a total of 382 partial onychectomies (151 group A; 231 group B). Group B patients exhibited a lower recurrence rate (4.7%) when compared to group A (11.2%, p = .02), and had a lower postoperative infection rate (4.0% group A vs. 1.7% group B; p = .18), although not statistically significant.
CONCLUSIONS: Silver nitrate chemical matricectomy after partial onychectomy is an effective treatment for IT in adolescents, with few postoperative complications and low recurrence rate. Therefore, it should be considered as a possible alternative to electrocautery matricectomy.

OBJECTIVE: Onychocryptosis is one of the most prevalent onychopathies, being a frequent reason for consultation in podiatric clinical practice. Conservative treatments are the first therapeutic choice, with nail remodeling using clotrimazole gel emerging as an alternative, although its medium-term effectiveness is unknown. The objective of this study was therefore to compare the efficacy of the technique of nail retraining using gauze bandaging with that of nail remodeling for the conservative treatment of stage I and IIA onychocryptosis.
METHODS: An analytical, randomized clinical trial study was performed following a longitudinal and prospective design. A sample was selected of 20 subjects presenting stage I and IIA onychocryptosis. Of these, 10 cases formed the group of nail retraining using gauze bandaging, and the other 10 the nail remodeling group. The presence of recurrence in a 3-month period was evaluated.
RESULTS: Before the intervention, the patients in the retraining group presented pain of 6.7 ± 1.9 vs. 6.8 ± 1.6 in the remodeling group, with no significant difference between the two (p = 0.900). After the 3-month follow-up period, seven of the retraining group patients presented recurrence of onychocryptosis vs. only one in the remodeling group.
CONCLUSIONS: The technique of nail remodeling has a lower recurrence rate than that of nail retraining with gauze bandaging, with the pain, inflammation, and infection reported being less, and with greater patient satisfaction.

BACKGROUND: Many surgical techniques have been reported for treatment of ingrown toenails. Occurrence of infection after matricectomy procedures could cause clinicians to prefer using external braces in the treatment of ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique.
METHODS: Patients who underwent ingrown toenail surgery were reviewed retrospectively. The patients\' demographic characteristics (ie, age, gender, body mass index morphology according to Heifetz classification, surgical technique, visual analogue scale values, time to return to daily activities [days], complications, and satisfaction levels) were all recorded.
RESULTS: Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients\' age, gender, body mass index, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and visual analogue scale values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique.
CONCLUSIONS: Nail fixation can be an effective surgical treatment option for ingrown toenail.