Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention

Sangar Abdullah; Güney Özkaya; Mahmut Zenciroğlu; Mustafa Kağan Başdoğan

Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention

Abstract

Aims: Partial matricectomy by the Winograd technique is a common surgical treatment for ingrown toenail, and several modifications have been described. This study compared the classic Winograd technique with primary suture against a modified technique in which the wound is left open to heal by secondary intention. Methods: The records of patients who underwent surgery for Heifetz stage 2 or 3 ingrown toenail of the great toe between February 2021 and November 2023 at a tertiary training and research hospital were reviewed retrospectively, with follow-up completed in November 2024. Patients with diabetes mellitus, previous surgery for recurrent disease, or total nail excision were excluded. A single index nail was analysed per patient. The primary outcome was time to return to work or usual daily activities; secondary outcomes were recurrence, surgical site infection, and patient satisfaction. Recurrence was analysed using Kaplan-Meier and Cox proportional hazards methods. Results: Of 171 patients screened, 131 were analysed (66 classic Winograd, 65 modified). Median follow-up was 24.8 months. Return to work or usual daily activities was one day earlier after the classic technique (median 9 versus 10 days; p=0.011; Hodges–Lehmann median difference 1 day, 95% CI 0 to 2). Recurrence occurred in 12.1% and 10.8% respectively, with no difference in recurrence-free survival (log-rank p=0.95; HR 0.97, 95% CI 0.35–2.67). Surgical site infection (9.1% versus 12.3%, p=0.585) and satisfaction (92.4% versus 89.2% satisfied or very satisfied, p=0.561) did not differ significantly. Conclusion: No statistically significant differences in recurrence, infection, or satisfaction were observed between the techniques, with a clinically small difference in return to work.

Keywords

Supporting Institution

None. This study received no financial support

Ethical Statement

The study was approved by the Clinical Research Ethics Committee of Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital (Date: 28.10.2024, Decision No: E-46059653-050.99-257905036). The study was conducted in accordance with the Declaration of Helsinki.

Thanks

None

References

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Details

Primary Language

English

Subjects

General Surgery

Journal Section

Research Article

Authors

Sangar Abdullah ^*
0009-0009-8046-8490
Türkiye

Güney Özkaya
0000-0003-0101-7368
Türkiye

Mahmut Zenciroğlu
0000-0002-2992-8238
Türkiye

Mustafa Kağan Başdoğan
0000-0002-5551-4944
Türkiye

Publication Date

October 25, 2026

Submission Date

August 5, 2026

Acceptance Date

September 10, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA65XY36FH

Cite

RIS / Bibtex

APA

Abdullah, S., Özkaya, G., Zenciroğlu, M., & Başdoğan, M. K. (2026). Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention. Journal of Medicine and Palliative Care, 7(5), 1022-1028. https://izlik.org/JA65XY36FH

AMA

1.Abdullah S, Özkaya G, Zenciroğlu M, Başdoğan MK. Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):1022-1028. https://izlik.org/JA65XY36FH

Chicago

Abdullah, Sangar, Güney Özkaya, Mahmut Zenciroğlu, and Mustafa Kağan Başdoğan. 2026. “Classic versus Modified Winograd Technique for Ingrown Toenail: A Retrospective Comparison of Primary Suture and Healing by Secondary Intention”. Journal of Medicine and Palliative Care 7 (5): 1022-28. https://izlik.org/JA65XY36FH.

EndNote

Abdullah S, Özkaya G, Zenciroğlu M, Başdoğan MK (October 1, 2026) Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention. Journal of Medicine and Palliative Care 7 5 1022–1028.

IEEE

[1]S. Abdullah, G. Özkaya, M. Zenciroğlu, and M. K. Başdoğan, “Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 1022–1028, Oct. 2026, [Online]. Available: https://izlik.org/JA65XY36FH

ISNAD

Abdullah, Sangar - Özkaya, Güney - Zenciroğlu, Mahmut - Başdoğan, Mustafa Kağan. “Classic versus Modified Winograd Technique for Ingrown Toenail: A Retrospective Comparison of Primary Suture and Healing by Secondary Intention”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 1022-1028. https://izlik.org/JA65XY36FH.

JAMA

1.Abdullah S, Özkaya G, Zenciroğlu M, Başdoğan MK. Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention. J Med Palliat Care / JOMPAC / jompac. 2026;7:1022–1028.

MLA

Abdullah, Sangar, et al. “Classic versus Modified Winograd Technique for Ingrown Toenail: A Retrospective Comparison of Primary Suture and Healing by Secondary Intention”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 1022-8, https://izlik.org/JA65XY36FH.

Vancouver

1.Sangar Abdullah, Güney Özkaya, Mahmut Zenciroğlu, Mustafa Kağan Başdoğan. Classic versus modified Winograd technique for ingrown toenail: a retrospective comparison of primary suture and healing by secondary intention. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):1022-8. Available from: https://izlik.org/JA65XY36FH