title: Comparison between knot and Winograd techniques on ingrown nail treatment.
abstract: OBJECTIVE
  The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This study also aimed to determine the etiology of ingrown nails, whether due to involvement of the nail or soft tissue.
  
  
  METHODS
  Seventy-five patients with a total of 90 ingrown nails (stages 2 and 3) who presented at our clinic between 2012-2014 were included in this study. Patients were divided into 2 groups: those treated with the knot technique and those treated with the Winograd technique. Patients in both groups were evaluated for the amount of local anesthetic required, intraoperative pain, effectiveness of preventing/stopping hemorrhage, surgery time, complications, postoperative nail size, recurrence, nail deformities, and secondary surgery rates.
  
  
  RESULTS
  The mean surgical time, relapse rate, number of additional surgeries required, and amount of local anesthetic were significantly greater in the Winograd group than in the knot group. The mean nail diameter was significantly decreased, with a mean of 3 mm in the Winograd group. No statistically significant differences were found between the groups in the incidence of infection, intraoperative pain, hematoma, or nail deformity.
  
  
  CONCLUSIONS
  This study demonstrated that the knot technique, consisting of wedge excision of soft tissue without affecting the nail itself, is a simple technique to treat ingrown nails with a lower complication rate and shorter surgical time. We believe that successful treatment of ingrown nails depends only on excision of soft tissue, with no need to operate on the nail bed.
authors.affiliation: Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey.
authors.forename: Bilsev
authors.initials: B
authors.lastname: İnce
authors.affiliation: Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dadacı
authors.affiliation: Kahramanmaraş State Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Kahramanmaraş, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Bilgen
authors.affiliation: Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Yarar
mesh_terms: D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009263:Nails, Ingrown / Q000601:surgery*; D061646:Operative Time; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D055815:Young Adult