Erişkinlerde Tırnak Batmasının Matriksektomisiz Cerrahi Tedavisi

Abstract

Amaç: Tırnak batması ileri evrelerde cerrahi tedavi gerektiren önemli bir ayak problemidir. Te-davi için birçok cerrahi yöntem bildirilmiştir. Bu çalışmanın amacı, ileri evre ayak tırnakları batık hastalarda matriksektomi yapılmadan batık ayak tırnağı ameliyatının sonuçlarını değerlendirmek-tir.
Materyal ve Metod: Çalışmaya 22 hasta dahil edildi. Tüm hastalara cerrahi öncesi ve sonrasında ayakkabı giyebildiklerinde görsel analog skala (ağrı / memnuniyet) uygulandı ve hastaların ra-hatsızlık duymadan ayakkabı giyme zamanlaması sorgulandı.
Bulgular: Preoperatif VAS (ağrı) skoru ayakkabı giyebildikten sonra 8.2 ± 1.1'den 2.4 ± 1.2'ye anlamlı olarak düzeldi (p<0.05). Rahatsızlık olmadan ayakkabı giyme zamanlaması ameliyattan sonra 13.3 ± 2.7 gün idi. İki hastada (% 7,1) rekürrens saptandı. Takipte tırnak distrofileri ve tırnak uzama problemleri görülmedi.
Sonuç: Matriksektomi yapılmadan tırnak batması cerrahi uygulanan ileri evre hastalarda başarılı sonuçlar alınabilir, rekürrensi azaltmak için yeterli yumuşak doku eksizyonu yapmaya özen gösterilmelidir.

Anahtar kelimeler: Tırnak batması, Matriksektomi, Tırnak distrofisi

Keywords

• Tırnak batması
• Matrisektomi
• Tırnak distrofisi

Surgical Treatment of Ingrown Nail Without Matricectomy in Adults

Abstract

Background: Ingrown toenail is an important foot problem that requires surgical treatment in advanced stages. Many surgical methods have been reported for treatment. The aim of this study was to evaluate the results of ingrown toenail surgery without matricectomy performed in patients with advanced stage ingrown toenails.
Materials and Methods: Twenty two patients were included in the study. Visual analog scale (pain / satisfaction) was applied to all patients before and after shoe wearing, and the patients were questioned regarding the timing of shoe wearing without discomfort.
Results: Preoperative VAS (pain) score was significantly improved from 8.2±1.1 to 2.4±1.2 after shoe wearing (p<0.05). The mean timing for shoe wearing without discomfort was 13.3±2.7 day after the surgery. Recurrences were found in two patients (7.1%). Nail dystrophies and nail growing problems were not seen during follow-up.
Conclusions: Successful results can be obtained in advanced stage patients with ingrown toenail surgery without matricectomy, care should be taken to make adequate soft tissue excision to reduce recurrence.

Key Words: Ingrown toenail, Matricectomy, Nail dystrophy

Keywords

• Ingrown toenail
• Matricectomy
• Nail dystrophy

References

1. 1- Noël B. Surgical treatment of ingrown toenail without matricectomy. Dermatol Surg 2008; 34(1): 79-83.
2. 2- Küçüktaş M, Kutlubay Z, Yardimci G, Khatib R, Tüzün Y. Comparison of effectiveness of electrocautery and cryotherapy in partial matrixectomy after partial nail extraction in the treatment of ingrown nails. Dermatol Surg 2013; 39(2): 274-80.
3. 3- Aydin N, Kocaoglu B, Esemenli T. Partial removal of nail matrix in the treatment of ingrown toe nail. Acta Orthop Traumatol Turc 2008; 42: 174–7.
4. 4- Kruijff S, Van Det RJ, Van der Meer GT, et al. Partial matrix excision or orthonyxia for ingrown toenails. J Am Coll Surg 2008; 206: 148–53.
5. 5- Tatlican S, Eren C, Yamangokturk B, Eskioglu F. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrown toenails in people with diabetes. Dermatol Surg 2010; 36: 219–22.
6. 6- Martínez-Nova A, Sánchez-Rodríguez R, Alonso-Peña D. A new onychocryptosis classification and treatment plan. J Am Podiatr Med Assoc 2007; 97(5): 389-93.
7. 7- Persichetti P, Simone P, Li Vecchi G, Di Lella F, Cagli B, Marangi GF. Wedge excision of the nail fold in the treatment of ingrown toenail. Ann Plast Surg 2004; 52(6): 617-20.
8. 8- Ozdemir E, Bostanci S, Ekmekci P, Gurgey E. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowing toenails. Dermatol Surg 2004; 30(1): 26-31.

9. 9- Acar E. Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails. J Foot Ankle Surg 2017; 56(3): 474-77.
10. 10- Terzi E, Guvenc U, Tursen B, Tursen U, Kaya TI. The Effectiveness of Matrix Cauterization With Bichloracetic Acid in the Treatment of Ingrown Toenails. Dermatol Surg 2017; 43(5): 728-33.