title: How low should you go: novel device for nail trephination.
abstract: BACKGROUND
  The most commonly used treatment for subungual hematomas is nail trephination, a technique that is not standardized and that poorly controls for trephination depth.
  
  
  OBJECTIVE
  The objective was to test the safety and tolerance of a new device for nail trephination that uses innovative "mesoscission" or microcutting technology to create holes of specific depths in the nail plate without penetrating the nail bed.
  
  
  METHODS
  Fourteen adult subjects with healthy toenails had five holes drilled in a random single-blind fashion at different test settings into their right great toenail with this device and were assessed for pain and pressure tolerance as well as perioperative and postoperative complications.
  
  
  RESULTS
  Nail trephination with this device in this small pilot study was controlled and well tolerated.
  
  
  CONCLUSIONS
  The study population was small (n = 14) and the follow-up evaluation relied on patient self-report, which is not always reliable. The follow-up period was only 1 week and did not allow for evaluation of permanent nail plate deformity.
  
  
  CONCLUSIONS
  Mesoscission may be a controlled and practical alternative to traditional nail trephining methods.
authors.affiliation: Clinical Unit for Research Trials in Skin, Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts 02115, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ciocon
authors.forename: T R
authors.initials: TR
authors.lastname: Gowrishankar
authors.forename: Terry
authors.initials: T
authors.lastname: Herndon
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Kimball
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000601:surgery*; D006801:Humans; D008297:Male; D009262:Nails / Q000293:injuries / Q000601:surgery*; D010865:Pilot Projects; D016037:Single-Blind Method; D016896:Treatment Outcome