ingrown nails

  • 文章类型: Journal Article
    背景技术内胎趾甲是导致慢性疼痛的常见病,反复感染,难以进行日常活动。我们的目的是比较两种治疗向内生长的脚趾甲的手术方法:楔形切除术和楔形切除术,然后对甲床进行电灼烧。方法A前瞻性,比较研究包括130例脚趾甲向内生长的患者。所有患者均为II期或III期疾病。根据手术类型将患者分为两组,所有患者均随访6个月。测量的结果是术后出血和感染的发生率,恢复时间,患者满意度,术后6个月复发率。结果在纳入的130例患者中,59例(45.4%)接受了指甲基质的切除和刮削(第1组),71例(54.6%)接受了切除,刮削,和指甲基质的电烧灼(第2组)。第1组和第2组术后感染率分别为20.3%和4.2%,分别(p=0.004)。第一组患者满意度为76.3%,而第二组91.5%的患者对手术效果满意。术后六个月,第一和第二组的复发率分别为25.4%和4.2%,分别(p=0.001)。结论楔形切除术和刮宫术,其次是向内生长的脚趾甲的电烧灼是一种安全的治疗方式,具有很高的成功率,较低的复发率证明了这一点,和更高的患者满意度,对术后疼痛评分或恢复时间无影响。
    Background  Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods  A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results  Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively ( p  = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively ( p  = 0.001). Conclusion  Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.
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  • 文章类型: Journal Article
    我们旨在确定日本糖尿病患者足部溃疡前病变的频率和危险因素。
    这是一项单中心横断面观察性研究。我们对5029名糖尿病患者(平均年龄63岁;2185名女性;1015名1型糖尿病患者和4014名2型糖尿病患者)进行了问卷调查,他们(a)参加了东京女子医科大学中心的糖尿病研究:DIACET2018,(b)对足部溃疡前病变的存在做出回应。足部溃疡前病变被定义为老茧,向内生长的指甲,或真菌感染的症状。使用逻辑回归分析检查了足部溃疡前病变与常用临床信息之间的关联。
    1015例(40.6%)1型糖尿病患者中的412例和4014例(39.5%)2型糖尿病患者中的1585例报告有任何类型的足部溃疡前病变。老茧的频率,向内生长的指甲,和真菌感染的症状,分别,为16.8%,15.8%,1型糖尿病占21.9%,10.5%,18.5%,2型糖尿病患者为24.7%。在按糖尿病类型进行的单独分析中,发现与足部溃疡前病变显著相关的常见危险因素是女性,麻木在脚和脚变形。
    卫生保健专业人员主动进行足部筛查被认为很重要,特别是在1型和2型糖尿病患者中,有晚期并发症和足部变形。
    在线版本包含补充材料,可在10.1007/s13340-023-00649-7获得。
    UNASSIGNED: We aimed to identify the frequency and risk factors of pre-ulcerative lesions of foot in Japanese individuals with diabetes.
    UNASSIGNED: This was a single-center cross-sectional observational study. We conducted a questionnaire survey of 5029 individuals with diabetes (mean age 63 years; 2185 women; 1015 individuals with type 1 diabetes and 4014 individuals with type 2 diabetes) who (a) participated in the Diabetes Study from the Center of Tokyo Women\'s Medical University: DIACET 2018, and (b) responded to the presence of pre-ulcerative lesions of foot. A pre-ulcerative lesions of foot was defined as a calluses, ingrown nails, or symptoms of fungal infection. The associations between pre-ulcerative lesions of foot and commonly available clinical information were examined using the logistic regression analysis.
    UNASSIGNED: 412 of 1015 (40.6%) individuals with type 1 diabetes and 1585 of 4014 (39.5%) individuals with type 2 diabetes reported having any type of pre-ulcerative lesions of foot. The frequency of calluses, ingrown nails, and symptoms of fungal infection, respectively, were 16.8%, 15.8%, and 21.9% in type 1 diabetes and 10.5%, 18.5%, and 24.7% in type 2 diabetes. In the separate analysis by type of diabetes, common risk factors found to be significantly correlated with pre-ulcerative lesions of foot were female gender, numbness in the feet and foot deformation.
    UNASSIGNED: Proactive foot screening by health care professionals was considered important, especially in individuals with type 1 and type 2 diabetes with advanced complications and foot deformation.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s13340-023-00649-7.
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  • 文章类型: Observational Study
    背景:尽管部分切除和化学基质切除术已被描述为首选治疗方法,在文献中,关于使用银盐进行基质切除术的证据很少。我们的目的是描述部分切除术后硝酸银用于基质烧灼的有效性。
    方法:在我们机构的2018-2019年期间,对2-3期足趾向内生长的患者进行了一项前瞻性观察性研究。所有患者均在术后第7天和第30天在门诊进行评估,迄今为止,手术后每6个月进行一次电话评估。
    结果:123名患者,接受了231例硝酸银化学矩阵切除术的部分检查,中位随访时间为21个月(四分位数间距,12-29).该程序的有效性为95.3%,到目前为止,随访报告只有11例复发(4.7%)。术后感染4例(1.7%)。不利影响,如疼痛和术后引流,对大多数病人来说都无关紧要。
    结论:隆甲部分切除术后的硝酸银矩阵切除术是治疗儿童嵌甲的有效和安全的替代方法,术后死亡率低,复发率低。
    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.
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  • 文章类型: Journal Article
    背景:部分切除和化学基质切除术被认为是治疗II-III期向内生长的脚趾甲(IT)的金标准。然而,很少有报道描述硝酸银在青少年IT管理中的使用。我们的目的是分析硝酸银进行基质消融的有效性,并将其与通过电灼进行的部分切除术进行比较。
    方法:对患有II-III期IT的青少年患者进行回顾性研究。比较了在大型门诊手术中心(A组)接受电灼基质切除术的人和在门诊接受硝酸银治疗的人(B组)。疗效由复发率和术后感染率决定。
    结果:共纳入两百零九例患者(A组86例;B组123例),共有382例部分检查(A组151例;B组231例)。B组患者的复发率(4.7%)低于A组(11.2%,p=.02),术后感染率较低(A组4.0%vs.B组1.7%;p=.18),虽然没有统计学意义。
    结论:男性部分切除术后的硝酸银化学基质切除术是治疗青少年IT的有效方法,术后并发症少,复发率低。因此,它应该被认为是一种可能的替代电灼矩阵切除术。
    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.
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  • 文章类型: Observational Study
    背景:虽然部分切除和化学基质切除术已被描述为首选治疗方法,文献中关于使用硝酸银进行基质切除术的证据很少。我们的目的是描述部分切除术后硝酸银用于基质烧灼的有效性。
    方法:在我们机构的2018-2019年期间,对向内生长的2-3期脚趾甲患者进行了部分切除术和硝酸银化学基质切除术。所有患者均在术后第7天和第30天在门诊进行评估,迄今为止,在外科手术后每6个月进行一次电话评估。
    结果:123名患者,接受了231例硝酸银化学矩阵切除术的部分检查,中位随访时间为21个月(四分位数间距,12-29).该程序的有效性为95.3%,到目前为止,随访中仅报告了11例复发(4.7%)。术后感染4例(1.7%)。不利影响,如疼痛和术后引流,在大多数患者中无关紧要。
    结论:部分隆甲切除术后的硝酸银矩阵切除术是治疗儿童嵌甲的有效和安全的替代方法,术后发病率低,复发率低。
    BACKGROUND: Although partial onychectomy with chemical matricectomy has been described as the treatment of choice, there is sparse evidence in the literature regarding the use of silver nitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrix cauterization after partial onychectomy.
    METHODS: A prospective observational study was performed on patients with ingrown toenails stage 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 after the 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 recurrences (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 most patients.
    CONCLUSIONS: Silver nitrate matricectomy after partial onychectomy is an effective and safe alternative for the treatment of ingrown toenail in children, with scarce postoperative morbidity and low recurrence rate.
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  • 文章类型: Journal Article
    目的:本研究旨在比较Winograd和改良Winograd方法对指甲向内生长患者的临床结局的影响。
    方法:总共,在2019年12月至2020年12月期间接受了向内生长的脚趾甲手术的45例患者被随机分组。在这项研究中,研究了作者应用的不同方法,每个作者采用的方法分为两个单独的组。所有患者均进行了部分生发基质和甲床切除术。三十(53.6%)的指甲是用纱布穿的,留下指甲的切除区域未缝合(第1组)。然后,其余26个指甲(第2组)用床垫缝合技术缝合,以确保皮肤在指甲下。临床结果,视觉模拟量表(VAS)评分,并对言语满意度状况进行统计评价。
    结果:在我们的研究中,对45例患者的56枚指甲进行了回顾性评估。术后随访10~19个月,平均13个月。平均年龄为27.13(15-48)岁。总的来说,31(68.9%)的患者是男性,14名(31.1%)为女性。缝合组术后出血和肉芽组织发育的发生率降低。在第1组中,手术后肥大肉芽组织的发展对VAS评分和恢复时间有明显的负面影响。在缝合组中,患者恢复工作或进行较短时间的日常生活活动。大约95%的患者感到满意或非常满意。
    结论:使用适当的缝合技术进行部分基质切除与快速恢复相关,复发率低,患者满意度高,并在接受脚趾甲治疗的患者中更早恢复日常生活的工作活动。
    OBJECTIVE: This study aimed to compare the effects of the Winograd and modified Winograd methods for nail bed suturing on clinical outcomes in patients with nail ingrown.
    METHODS: In total, 45 patients who underwent surgery for ingrown toenails between December 2019 and December 2020 were randomised retrospectively. In this study, different methods applied by the authors were studied, and the methods applied by each author were divided into two separate groups. All patients had partial germinal matrix and nail bed excisions. Thirty (53.6%) of the nails were dressed in gauze, leaving the excised area of ​​the nail unsutured (group 1). Then, the remaining 26 nails (group 2) were sutured with the mattress suturing technique to ensure that the skin was under the nail. Clinical outcomes, visual analogue scale (VAS) scores, and verbal satisfaction status were statistically evaluated.
    RESULTS: In our study, 56 nails of 45 patients were evaluated retrospectively. The patients were followed up for an average of 13 (10-19) months. The mean age was 27.13 (15--48) years. In total, 31 (68.9%) of the patients were men, and 14 (31.1%) were women. The incidence of postoperative bleeding and granulation tissue development decreased in the sutured group. In group 1, the development of hypertrophic granulation tissue after surgery had a significantly negative impact on VAS score and recovery time. In the sutured group, patients returned to work or performed activities of daily living for a shorter period. Approximately 95% of patients were satisfied or extremely satisfied.
    CONCLUSIONS: Partial matrix excision using the appropriate suturing technique is associated with a fast recovery, low recurrence rate, high patient satisfaction, and earlier return to work activities of daily life among patients treated for ingrown toenails.
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  • 文章类型: Journal Article
    Although ingrown nail (IN) is common, there is no large-scale study regarding its epidemiology and risk factors, such as foot deformity. The purpose of this study is to determine the demographics of IN and clarify its association with bone-related comorbidities of the ankle, foot and toe. Patients in a representative sample cohort of the National Health Information Database of South Korea from 2004 to 2013 who had IN were compared with a control group without IN. Ten-year overall incidence was 307.5/100 000 person-years (95% confidence interval, 304.1-310.9). IN incidence and prevalence showed an increasing trend, and IN was more common in women than in men. Incidence showed bimodal peaks, among teenagers and among participants in their 50s. The IN group showed more common valgus deformity (64.3%) than did the control group (61.6%), and flat foot was also a significant risk factor of IN. There were increasing tendencies of IN incidence and prevalence among females. Confirmed bone deformity, especially acquired valgus or varus deformity, and flat foot were associated with IN.
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  • 文章类型: Journal Article
    The aim of this study was to compare the result of electrocauterization and curettage, which can be done with basic instruments. Patients with ingrown nail were randomized to 2 groups. In the first group, nail matrix was removed by curettage, and the second group, nail matrix was removed by electrocautery. A total of 61 patients were enrolled; 32 patients were operated by curettage, and 29 patients were operated by electrocautery. Wound infections, as early complication, were found in 15.6% (5/32) of the curettage group, 10.3% (3/29) of the electrocautery group patients each (P = .710). Nonrecurrence was observed in 93.8% (30/32) and 86.2% (25/29) of the curettage and electrocautery groups, respectively, (lower limit of 1-sided 90% confidence interval = -2.3% > -15% [noninferiority margin]). To remove nail matrix, the curettage is effective as well as the electrocauterization. Further study is required to determine the differences between the procedures.
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