背景:使用苯酚(CMP)的化学基质切除术是一种公认的治疗方法。然而,合适的苯酚施用时间来实现指甲基质的破坏仍是未知的。最佳消融导致低复发率。这项研究的目的是评估接受4分钟CMP治疗的622名连续患者的甲癣复发率。
方法:我们招募了所有在意大利PodologicoItaliano进行4分钟CMP的患者,罗马,意大利,2008-2017年。术后随访时间为24h,7、14、21和28天,6个月,手术后1年。我们使用校正逻辑回归来评估疾病复发的潜在危险因素,包括年龄,性别,脚趾形状,合并症,和疾病定位。
结果:所有接受4分钟CMP治疗的患者的复发风险为1.1%(n=622,95%CI=0.5%-2.3%)。在心血管疾病患者亚组(n=39)中,复发风险为5.1%(95%CI=0.61-7.3)。年轻的年龄也与复发几率增加相关(p=0.036)。
结论:在这项观察性研究中,当使用CMP治疗甲癣时,没有中断的4分钟似乎是苯酚的适当施用时间。应进行随机对照试验以证实我们的结果。
BACKGROUND: Chemical matricectomy using phenol (CMP) is a recognized treatment option for
onychocryptosis. However, the appropriate phenol application time to achieve nail matrix destruction is still unknown. Optimal ablation leads to low recurrence rates. The aim of this research was to assess the recurrence rate of onychocryptosis in a cohort of 622 consecutive patients treated with a 4-min CMP.
METHODS: We recruited all patients undergoing a 4-min CMP for
onychocryptosis at the Istituto Podologico Italiano, Rome, Italy, in 2008-2017. Postoperative follow-up visits were set at 24 h, 7, 14, 21, and 28 days, 6 months, and 1 year after surgery. We used adjusted logistic regression to evaluate the potential risk factors for the disease recurrence including age, gender, toe shape, comorbidities, and disease localization.
RESULTS: The risk of recurrence in all patients treated with a 4-min CMP was 1.1% (n = 622, 95% CI = 0.5%-2.3%). In the subgroup of patients with cardiovascular disease (n = 39) the recurrence risk was 5.1% (95% CI = 0.61-7.3). Young age was also associated with increased odds of recurrence (p = 0.036).
CONCLUSIONS: In this observational
study, 4 min with no interruptions seems to be the appropriate application time of phenol when using CMP for the treatment of
onychocryptosis. A randomized controlled
trial should be carried out to confirm our results.