Telephone follow-up after outpatient nail surgery - a retrospective analysis.

BACKGROUND: One of the areas of care in dermatosurgery is the surgical treatment of diseases of the nail organ. Side effects and complications after nail surgery were investigated by telephone follow-up (TFU), and its suitability for postoperative monitoring and consultation was assessed. PATIENTS AND METHODS: All patients who underwent nail surgery at the Department of Dermatology at the Ludwigshafen City Hospital from October 2019 to December 2021 in outpatient setting were contacted by telephone on the second to third postoperative day and questioned in a standardized manner about postoperative complaints and counselled if necessary. RESULTS: A total of 100 cases were followed up. The most common procedures performed were phenol matricectomy (41%), nail avulsion (16%), and nail matrix biopsies (9%). 50% and 21% of patients reported pain on the day of the procedure and the day after surgery, respectively. After nail avulsion, pain was statistically significantly more frequently reported on the day following the procedure and pain medication was statistically significantly more frequently required (p  =  0.002). Serious adverse events did not occur after nail surgery. 10% of the respondents raised specific questions and needed counseling by TFU. CONCLUSIONS: All nail surgeries were well tolerated in the outpatient setting. Pain was the most common side effect, although only half of all patients reported pain on the day of surgery and only 21% on the day after the procedure. The TFU proved to be an effective and practical as well as easy to establish method for postoperative follow-up and consultation after outpatient nail surgery.

Congenital malalignment of the great toenail: Conservative and definitive treatment.

Congenital malalignment of the great toenail, or ungual malalignment, is a rarely recognized disorder. It is characterized by lateral deviation of the longitudinal axis of the nail plate with respect to the distal phalanx, and if untreated, complications in the late teens and adulthood may arise. In this study, we have reviewed conservative and definitive treatments for this disorder.

The perils of dressings: a cautionary tale of ischaemia.

A cohort of patients presented to Queen Victoria Hospital, UK, with iatrogenic toe ischaemia following application of a different, newly available post-procedure dressing with different properties to those usually used. This resulted in ischaemia with extensive skin and soft tissue damage, requiring debridement surgery and, in some cases, skin grafting. We aim to highlight the risk of morbidity from dressing application to the digits. This is a key learning skill for anyone who may either perform dressings or evaluate dressings on digits in the community and across multiple specialties in hospital. This article follows a thorough root cause analysis and addresses other possible causes of an acutely painful erythematous toe post-Zadek's procedure.

Modified shave surgery combined with nail window technique for the treatment of longitudinal melanonychia: Evaluation of the method on a series of 67 cases.

BACKGROUND: Nail matrix histopathologic examination is still the criterion standard to diagnose longitudinal melanonychia (LM). OBJECTIVE: To introduce modified shave surgery combined with the nail window technique for managing LM and evaluate the postoperative outcome of the procedure. METHODS: We retrospectively reviewed the medical records of 67 patients with LM who underwent shave surgery combined with the longitudinal-strip nail window technique at our institution from March 2015 to June 2018. RESULTS: Pathologic diagnosis was accessible in all cases, and 60 cases were assessable for the postoperative outcomes. A total of 45 cases (75.0%) had no postoperative nail dystrophy, and recurrence of nail pigmentation was found in only 8 cases (13.3%). LIMITATIONS: This was a retrospective study. CONCLUSION: Modified shave surgery combined with the nail window technique is the preferable management for LM cases, with limited postoperative nail dystrophy and recurrence of pigmentation.

[Mucous pseudocysts-when and how to treat?] / Mukoide Pseudozysten ­ wann wie therapieren?

The treatment of mucous pseudocysts must consider their tendency for recurrence. There are numerous established treatment options available. The decision on the optimal therapy, however, depends on the clinical presentation and symptoms as well as on possible side effects. This review presents surgical as well as nonsurgical treatment options for digital mucous pseudocysts and an algorithm is suggested. For recurrent and symptomatic lesions with pain or deformation of the nail plate, surgical excision of the pseudocyst and closure with a flap can be considered.

[Ingrown toenails-options for daily practice]. / Eingewachsene Zehennägel ­ Optionen für die tägliche Praxis.

The ingrown toenail is a common, painful and inflammatory clinical presentation, especially, but not exclusively, in adolescent patients. Numerous conservative treatment methods are available. Usually, however, the surgical treatment is at the end of a chain of suffering. While classified as obsolete, the so-called Emmert plasty is still used for surgical treatment. As a gentle alternative, selective treatment of the lateral matrix horn by resection or phenol caustics is increasingly used. The latter methods offer numerous benefits with little postoperative pain and faster recovery to normal quality of life.

[The Evaluation of Calcium Alginate Dressing Helping Wound Healing of Nail Surgery].

OBJECTIVE: To determine the effect of calcium alginate dressing therapy on wound healing after nail surgery. METHODS: Patients with nail surgery on nail bed of great toe were divide into two groups (20 caces for each group) randomly based on random number table. Calcium alginate dressing were used in treatment group after nail surgery and the vaseline gauze were applied in control group after surgery. The number of wound remain bleeding and the rating of pain [visual analogue scale (VAS)] scores were observed for three times (24 h, 48 h and 72 h). Median time of pain bearing and time of wound healing were also observed. RESULTS: There were 16 males and 4 females in control group [mean age (37.45±3.30) yr.]. There were 12 males and 8 females in treatment group [mean age (33.40±3.13) yr.].There were no significant differences in sex ratio and age between the two groups (P>0.05). No infection was found in the treatment group, but 1 case in the control group. The number of bleeding cases in treatment group was less than that in control group (P<0.05), as well as the VAS scores 24 h after nail surgery (P<0.05). At 48 h, no bleeding occurred in the traetment group, while there were 2 cases of bleeding in the control group (P>0.05); the VAS score in treatment group was less than that in control group (P<0.05). At 72 h, no bleeding was observed in both groups, and the difference in VAS score between the two groups was not statistically significant (P>0.05). The median time of pain bearing was 24 h in treatment group while 72 h in control group. Wound healing time of treatment group (9.40 d) and control group (11.35 d) was statistically significant (P<0.05). CONCLUSION: Calcium alginate dressing therapy can promote postoperative wound recovery and block bleeding and pain after nail surgery.

[Clinical MedicineThe Evaluation of He-Ne Laser Therapy Help Wound Healing of Nail Surgery].

OBJECTIVES: To investigate the effect of He-Ne laser therapy on wound healing after nail surgery. METHODS: Patients who needed nail surgery were divided into treatment group (n=20) and control group (n=20) randomly.The He-Ne laser was applied to the wound after nail surgery in treatment group. The wound healing time, the inflammation duration, the pain rating, and the nail plate full-grown time were compared with control group. RESULTS: No significant differences in baseline of two groups were observed. The wound healing time was (16.00±2.51) d in control group and (11.35±1.73 ) d in treatment group, the inflammation duration was (9.10±2.10) d in control group and (7.20±1.44) d in treatment group (P<0.05), both above differences were significant (P<0.05).The nail plate full-grown time was (21.00±2.13) weeks in treatment group, whereas (21.40±1.05) weeks in control group (P>0.05).The pain rating of the 2 groups was different from 25 h (after 3 times treatment)(P<0.05). Pain disappeared in 85.0% (17/20) patients of treatment group after 49 h (5 times treatment), and completely disappeared (20/20) after 54 h (6 times treatment), which were faster than those of control group at the same time points (pain disappeared only in 50.0% and 98.5% of patients respectively). CONCLUSIONS: He-Ne laser therapy can help wound healing after nail surgery.

Super U Technique for Ingrown Nails. / Exéresis en U para la onicocriptosis.

INTRODUCTION AND OBJECTIVES: Ingrown nails are a common problem, seen mostly in young adults. Also known as onychcrypotisis, this condition typically affects the great toenail. Four stages have been defined according to the severity and duration of the condition, and treatment varies from conservative to surgical techniques depending on the stage. We present our experience with this condition, describing the characteristics of our population and surgical treatment, in particular the super U technique. MATERIAL AND METHODS: This was a retrospective, descriptive study of patients with ingrown great toenail treated surgically using the super U technique. We also describe postoperative management. RESULTS: Ten patients with a mean age of 35.7 years underwent operation, 9 for unilateral ingrown great toenail and 1 for bilateral disease. Stage II ingrown nail was the most common. Half of the patients had been treated previously using other surgical techniques. The mean time to healing was 6 weeks. The only postoperative complication was infection in 1 patient. Mild to moderate postoperative pain persisted for a week. The majority of patients were satisfied with the cosmetic result. CONCLUSIONS: We believe the super U technique is very useful in stage II ingrown nail and in disease that has recurred after previous surgery, and is the treatment of choice in stage III or IV disease in which excessive hypertrophic tissue is found.