DOI: 10.1111/j.1524-4725.2009.01466.x
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PMID: 20402951
Issn Print: 1076-0512
Publication Date: 2010/03/01
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Excerpt
We have recently demonstrated that sodium hydroxide matricectomy is as effective and safe for the treatment of ingrown toenails in people with diabetes as in those without.1 Phenol alcohol matricectomy is a widely used procedure for the treatment of ingrown toenails2 and is reported to be effective and safe in people with diabetes.3,4
Phenol is generally applied for 2 minutes for the treatment of ingrown toenails.5 In another study, we compared phenol applications of 1, 2, and 3 minutes in different groups and followed the patients postoperatively.1,6 Materials and methods and statistical analysis were described previously.1 Although patients treated with 2-minute phenol applications do not have diabetes, we compared the results of our two studies in terms of complete healing time, postoperative pain and drainage, periungual tissue damage, presence of infections, and rate of recurrences.
We found that the results with sodium hydroxide matricectomy in people with and without diabetes were better when compared with the results of phenol matricectomy in people without diabetes.
Mean complete healing time, mean duration of postoperative drainage, and periungual tissue damage in people without diabetes treated with phenol were significantly longer than in the two other groups. No postoperative infection was seen in any of the study groups. There were no significant differences between the groups regarding recurrence rates (Table 1).
The results of this retrospective study are probably related to the differences in chemical properties of sodium hydroxide and phenol for two reasons: sodium hydroxide has less destructive effects on tissue, and phenol cannot be neutralized by alcohol but can only be diluted.5,7
It is generally accepted that people with diabetes are more prone to postoperative complications such as prolonged healing time and infections than those without.5 In another study, sodium hydroxide and phenol matricectomies were compared in the treatment of ingrown toenails in a population without diabetes using the same parameters in our study, and the results are in accordance with the results of our study, indicating that sodium hydroxide is as effective as phenol and is safer.8
We propose that the use of sodium hydroxide instead of phenol for germinal matrix cauterization in the treatment of ingrown toenails in people with diabetes is as effective as phenol and is safer.
