Stage-3 Ingrown Toenail: SilverNitrate.mov

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added: 2011-08-19 views: 1523
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Case description

tags: silver nitrate procedure matricectomy onychocryptosis fungus

Silver nitrate is not my preferred medium to perform matricectomy; however, when an electrocautery unit is not available, this technique does provide for a reasonably well controlled matricectomy.
Onychocryptosis (ingrown toenail) is an inflammatory condition in which the body perceives the nail as a foreign object. I advance the staging system as follows:
Stage-1 Minor cryptosis that will likely resolve without invasive procedure (i.e., conservative management only).
Stage-2 Moderate cryptosis requiring minimally invasive treatment; (e.g., “Bevel Nail Resection,” which does not require matricectomy).
Stage-3 Advanced cryptosis that does require a partial matricectomy. This stage also includes the “Vandenbos Procedure” (i.e., surgical excision of the perionychium and distal fleshy overgrowth, which frees the nail and preserves cosmetics).
Stage-4 Advanced cryptosis which requires a complete matricectomy. I urge the least invasive procedure that will resolve ingrown toenail; sometimes however, for a variety of reasons, no reasonable options remain other than removing the nail permanently.