The effect of phenol on ingrown toenail excision in children.
OBJECTIVE
Ingrown toenails in children are a common problem with a high recurrence rate. The objective of this retrospective data review was to compare simple excision of the nail matrix with excision plus phenol (EPP) application in the treatment of ingrown toenails.


METHODS
The charts of 69 children who underwent surgical treatment of one or more ingrown toenails from 1994 to 2000 were reviewed. The primary procedure was noted (excision alone [EA] vs EPP) and dates of recurrences and reoperations were recorded. Parents were then surveyed by phone regarding complications, cosmetic outcome, and overall satisfaction with the procedure. Five scale categories, ranging from "strongly agree" to "strongly disagree", were used, with responses of "strongly agree" and "agree" considered as a good outcome. Either Student's t test or the chi2 test (P < .05 considered significant) was used for analysis.


RESULTS
Thirty-one patients (45%) were in the EPP group whereas the remaining 38 had EA. Mean length of follow-up was 4.3 years for the EA group and 2.1 years for the EPP group. There was no difference in age at operation or length of follow-up between the 2 groups. Boys were predominant in both groups. The survey response rate was 50/69 (73%). The recurrence rate of ingrown toenails in the EA group was 42% vs 4% in the EPP group (P = .003). There were no significant differences in parental response with regard to operative experience (P = .31) and the cosmetic result (P = .13), with most of the respondents (78%) indicating a good outcome for both questions.


CONCLUSIONS
The addition of phenol to the surgical excision of ingrown toenail significantly reduced the incidence of recurrence, with similar patient satisfaction and an equivalent cosmetic result.
Islam
Saleem
S
CS Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Lin
Erin McKean
EM
Drongowski
Robert
R
Teitelbaum
Daniel H
DH
Coran
Arnold G
AG
Geiger
James D
JD
Hirschl
Ronald B
RB
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009262:Nails; D009263:Nails, Ingrown / Q000188:drug therapy* / Q000601:surgery*; D017060:Patient Satisfaction; D019800:Phenol / Q000627:therapeutic use*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D055502:Secondary Prevention; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D019800:Phenol