Stage-3 ingrown Toenail: Electrocautery

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added:
13 years ago
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specialty:
Family Medicine

Case description

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.
• Stage-1 cryptosis, (ingrown toenail) will likely resolve with patient education alone (i.e., teaching the patient how to file their toenails and never use fingernail clipper, never, ever!)
• Stage-2 cryptosis, requires only trimming the leading edge of the nail in the shape of a bevel shape. This often allows for the toenail to escape the fleshy barricade (the crypt).
• Stage-3, the subject of this video, the partial nail resection with matricectomy by electrocautery.
• Stage-4, the extraction of the nail followed by total ablation of the nail matrix (matricectomy). This procedure should be reserved for advanced cryptosis and after informed consent (consulting with and confirming the patient's understanding of the procedure) and only then after thoughtful reflection. After performing a stage-4 matricectomy the toenail from ever growing back. Hope this helps and you may email me directly through my website, http://health4men.info/

tags: electrocauterization matricectomy onychocryptosis fungus


Julia  Krzywon
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Julia Krzywon

MD

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