Araştırma Makalesi
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Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails

Yıl 2025, Cilt: 15 Sayı: 3, 327 - 333, 05.01.2026

Öz

Aim: To compare the clinical and cosmetic outcomes of the novel Pulpar-Far resection with the conventional Winograd technique in the surgical treatment of stage 2 and 3 onychocryptosis.
Materials and Methods: This retrospective cohort study included 108 patients (mean age, 27.57 years) who underwent surgical treatment for stage 2 or 3 onychocryptosis between November 2021 and November 2023. Patients were treated with either the Pulpar- Far resection (n=54) or the Winograd procedure (n=54). Clinical outcomes included postoperative pain assessed using the Visual Analog Scale (VAS), recovery time, and time to return to daily activities. Recurrence rates and patient-reported cosmetic satisfaction were also evaluated. All patients had a minimum follow-up of 12 months, with a mean follow-up duration of 20.17±7.88 months.
Results: Patients who underwent the Pulpar-Far resection showed significantly quicker recovery (12.72±1.47 vs. 17.61±2.39 days; p <0.001) and an earlier return to activities (3.80±1.23 vs. 7.46±2.27 days; p <0.001) compared to those who had the Winograd procedure. One-week postoperative VAS pain scores were notably lower in the Pulpar-Far group (3.20±0.96 vs. 5.35±1.23; p <0.001). Cosmetic satisfaction was also higher in the Pulpar-Far group (98.1% vs. 81.48%; p <0.001). Although recurrence rates were lower with Pulpar-Far resection (1.85% vs. 9.26%), this difference was not statistically significant (p=0.204).
Conclusion: Pulpar-Far resection provides superior postoperative recovery, reduced pain, and improved cosmetic satisfaction compared with the Winograd technique in the treatment of advanced onychocryptosis. As a novel surgical approach, it represents a promising alternative, particularly for patients in whom aesthetic outcomes are a priority.

Kaynakça

  • 1. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009;79(4):303–308. PMID:19235497.
  • 2. Exley V, Jones K, O’Carroll G, Watson J, Backhouse M. A systematic review and meta-analysis of randomised controlled trials on surgical treatments for ingrown toenails part I. recurrence and relief of symptoms. J Foot Ankle Res. 2023;16(1):35.
  • 3. Tatlican S, Eren C, Yamangokturk B, Eskioglu F, Bostanci S. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrown toenails in people with diabetes. Dermatol Surg. 2010;36(2):219–22.
  • 4. Haneke E. Surgical treatment of ingrown toenails. Dermatol Surg. 2011;37(9):1289–1298.
  • 5. Yılmaz A, Çenesizoğlu E. Partial matricectomy with cryotherapy in treatment of ingrown toenails. Acta Orthop Traumatol Turc. 2016;50(3):262–8.
  • 6. Bianchi C, Cazzaniga S, Tosti A. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowing toenails: a prospective study. Dermatol Ther. 2020;33(6):e14005.
  • 7. Kim J, Lee S, Lee JS. A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure. Int J Environ Res Public Health. 2021;18(1):278.
  • 8. Kose O, Guler F, Gurcan S. Cosmetic results of wedge resection of nail matrix (Winograd technique) in the treatment of ingrown toenail. Foot Ankle Spec. 2012;5(4):241–244.
  • 9. Acar E. Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails. J Foot Ankle Surg. 2017;56(3):474–477.
  • 10. Vandenbos K, Bowers W. Ingrown toenail: a method of treatment. US Armed Forces Med J. 1959;10:384–391. PMID:13638794.
  • 11. Hassan RE, Khan L, Shah SH. Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements. Cureus. 2024;16(1):e52501.
  • 12. Misirovs R, Misirova J, Misirovs V. A comparative study of chemical matricectomy with 88% phenol and 10% sodium hydroxide for the treatment of ingrown toenails. Medicina (Kaunas) . 2021;57(6):556.
  • 13. Moriue T, Yoneda K, Moriue J. Comparison of partial nail avulsion with phenol and sodium hydroxide for the treatment of ingrown toenails. Dermatol Surg. 2012;38(12):2011–2015.
  • 14. Persichetti P, Simone P, Li Vecchi G. Wedge excision of the nail fold in the treatment of ingrown toenail. Ann Plast Surg. 2004;52(6):617–620.
  • 15. Zuber TJ. Ingrown toenail removal. Am Fam Physician. 2002;65(12):2547–2552. PMID:[12086244].
  • 16. Winograd AM. Resection of the nail matrix and nail bed. Arch Derm Syphilol. 1929;19(3):351–356.
  • 17. Oliveira F, Izquierdo-Cases JO, Martínez-Nova A, ContrerasBarragán E, Munuera-Martínez PV. The Modified versus the Conventional Winograd Technique for the Treatment of Onychocryptosis: A Retrospective Study. Int J Environ Res Public Health. 2022;19(13):7818.
  • 18. Kocak S, Ozyalcin A. Modified Winograd technique versus partial resection with electrocoagulation for surgical management of ingrown toenails. J Orthop Surg Res. 2025;20(1):361.
  • 19. Shang X, Jin Y, Meng X, Zhu H, Sun X, Xue Y, et al. A novel modified Winograd surgical tricks and tips with a “bird flap” for the treatment of ingrown toenails. Foot Ankle Surg. 2023;29(4):361–366.
  • 20. Ma J, Chen J, Guo Y. A Standardized Six-Step Procedure for Ingrown Toenail Treatment: Improving Outcomes and Reproducibility. Dermatol Ther. 2020;33(6):e14005.
  • 21. Herruer JM, Prins JB, van Heerbeek N, Ingels KJ. Negative predictors for satisfaction in patients after facial cosmetic surgery: A systematic review. J Plast Reconstr Aesthet Surg. 2015;68(11):1526–1532.
  • 22. Jacobson WE, Gorney M, Janowsky D. Psychiatric evaluation of patients requesting cosmetic surgery. Plast Reconstr Surg. 1977;59(4):486–492

Yıl 2025, Cilt: 15 Sayı: 3, 327 - 333, 05.01.2026

Öz

Kaynakça

  • 1. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009;79(4):303–308. PMID:19235497.
  • 2. Exley V, Jones K, O’Carroll G, Watson J, Backhouse M. A systematic review and meta-analysis of randomised controlled trials on surgical treatments for ingrown toenails part I. recurrence and relief of symptoms. J Foot Ankle Res. 2023;16(1):35.
  • 3. Tatlican S, Eren C, Yamangokturk B, Eskioglu F, Bostanci S. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrown toenails in people with diabetes. Dermatol Surg. 2010;36(2):219–22.
  • 4. Haneke E. Surgical treatment of ingrown toenails. Dermatol Surg. 2011;37(9):1289–1298.
  • 5. Yılmaz A, Çenesizoğlu E. Partial matricectomy with cryotherapy in treatment of ingrown toenails. Acta Orthop Traumatol Turc. 2016;50(3):262–8.
  • 6. Bianchi C, Cazzaniga S, Tosti A. Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowing toenails: a prospective study. Dermatol Ther. 2020;33(6):e14005.
  • 7. Kim J, Lee S, Lee JS. A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure. Int J Environ Res Public Health. 2021;18(1):278.
  • 8. Kose O, Guler F, Gurcan S. Cosmetic results of wedge resection of nail matrix (Winograd technique) in the treatment of ingrown toenail. Foot Ankle Spec. 2012;5(4):241–244.
  • 9. Acar E. Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails. J Foot Ankle Surg. 2017;56(3):474–477.
  • 10. Vandenbos K, Bowers W. Ingrown toenail: a method of treatment. US Armed Forces Med J. 1959;10:384–391. PMID:13638794.
  • 11. Hassan RE, Khan L, Shah SH. Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements. Cureus. 2024;16(1):e52501.
  • 12. Misirovs R, Misirova J, Misirovs V. A comparative study of chemical matricectomy with 88% phenol and 10% sodium hydroxide for the treatment of ingrown toenails. Medicina (Kaunas) . 2021;57(6):556.
  • 13. Moriue T, Yoneda K, Moriue J. Comparison of partial nail avulsion with phenol and sodium hydroxide for the treatment of ingrown toenails. Dermatol Surg. 2012;38(12):2011–2015.
  • 14. Persichetti P, Simone P, Li Vecchi G. Wedge excision of the nail fold in the treatment of ingrown toenail. Ann Plast Surg. 2004;52(6):617–620.
  • 15. Zuber TJ. Ingrown toenail removal. Am Fam Physician. 2002;65(12):2547–2552. PMID:[12086244].
  • 16. Winograd AM. Resection of the nail matrix and nail bed. Arch Derm Syphilol. 1929;19(3):351–356.
  • 17. Oliveira F, Izquierdo-Cases JO, Martínez-Nova A, ContrerasBarragán E, Munuera-Martínez PV. The Modified versus the Conventional Winograd Technique for the Treatment of Onychocryptosis: A Retrospective Study. Int J Environ Res Public Health. 2022;19(13):7818.
  • 18. Kocak S, Ozyalcin A. Modified Winograd technique versus partial resection with electrocoagulation for surgical management of ingrown toenails. J Orthop Surg Res. 2025;20(1):361.
  • 19. Shang X, Jin Y, Meng X, Zhu H, Sun X, Xue Y, et al. A novel modified Winograd surgical tricks and tips with a “bird flap” for the treatment of ingrown toenails. Foot Ankle Surg. 2023;29(4):361–366.
  • 20. Ma J, Chen J, Guo Y. A Standardized Six-Step Procedure for Ingrown Toenail Treatment: Improving Outcomes and Reproducibility. Dermatol Ther. 2020;33(6):e14005.
  • 21. Herruer JM, Prins JB, van Heerbeek N, Ingels KJ. Negative predictors for satisfaction in patients after facial cosmetic surgery: A systematic review. J Plast Reconstr Aesthet Surg. 2015;68(11):1526–1532.
  • 22. Jacobson WE, Gorney M, Janowsky D. Psychiatric evaluation of patients requesting cosmetic surgery. Plast Reconstr Surg. 1977;59(4):486–492
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Araştırma Makalesi
Yazarlar

Ekrem Özdemir

Nasuhi Altay

Fatih Emre Topsakal

Mehmet Koçaslan Bu kişi benim

Erdem Yunus Uymur

Esra Demirel Bu kişi benim

Gönderilme Tarihi 29 Nisan 2025
Kabul Tarihi 24 Temmuz 2025
Yayımlanma Tarihi 5 Ocak 2026
Yayımlandığı Sayı Yıl 2025 Cilt: 15 Sayı: 3

Kaynak Göster

APA Özdemir, E., Altay, N., Topsakal, F. E., … Koçaslan, M. (2026). Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails. Kafkas Journal of Medical Sciences, 15(3), 327-333.
AMA Özdemir E, Altay N, Topsakal FE, Koçaslan M, Uymur EY, Demirel E. Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails. KAFKAS TIP BİL DERG. Ocak 2026;15(3):327-333.
Chicago Özdemir, Ekrem, Nasuhi Altay, Fatih Emre Topsakal, Mehmet Koçaslan, Erdem Yunus Uymur, ve Esra Demirel. “Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails”. Kafkas Journal of Medical Sciences 15, sy. 3 (Ocak 2026): 327-33.
EndNote Özdemir E, Altay N, Topsakal FE, Koçaslan M, Uymur EY, Demirel E (01 Ocak 2026) Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails. Kafkas Journal of Medical Sciences 15 3 327–333.
IEEE E. Özdemir, N. Altay, F. E. Topsakal, M. Koçaslan, E. Y. Uymur, ve E. Demirel, “Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails”, KAFKAS TIP BİL DERG, c. 15, sy. 3, ss. 327–333, 2026.
ISNAD Özdemir, Ekrem vd. “Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails”. Kafkas Journal of Medical Sciences 15/3 (Ocak2026), 327-333.
JAMA Özdemir E, Altay N, Topsakal FE, Koçaslan M, Uymur EY, Demirel E. Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails. KAFKAS TIP BİL DERG. 2026;15:327–333.
MLA Özdemir, Ekrem vd. “Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails”. Kafkas Journal of Medical Sciences, c. 15, sy. 3, 2026, ss. 327-33.
Vancouver Özdemir E, Altay N, Topsakal FE, Koçaslan M, Uymur EY, Demirel E. Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails. KAFKAS TIP BİL DERG. 2026;15(3):327-33.