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Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail

Chander Grover, Ananta Khurana, Sambit Nath Bhattacharya, Arun Sharma
Indian Journal of Dermatology, Venereology and Leprology 2015, 81 (5): 472-7

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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).

LIMITATIONS: Limited postsurgical follow up of 6 months is a limitation of the study.

CONCLUSION: Chemical matricectomy using NaOH is as efficacious as phenolisation, with the advantage of faster tissue normalization.

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