Precision in Care, Prevention in Practice
Presenter: Y
Doruk Bilgili
Affiliations: Bandırma
Onyedi Eylül University, Turkey
Presentation Type: Oral Presentation (Virtual)
Title: Management of ingrown toenail
🦶 Management of Ingrown Toenail
Ingrown toenail, medically known
as onychocryptosis, is a common foot condition in which the
edge of the nail grows into the surrounding skin. It most frequently affects
the great toe and can cause significant discomfort and
complications if not treated appropriately.
🔍 What Is an Ingrown Toenail?
An ingrown toenail occurs when the
nail plate penetrates the adjacent periungual soft tissue. This leads to:
·
⚡
Pain and tenderness
·
🔴 Redness (erythema)
·
swelling
(edema)
·
🦠
Infection in advanced cases
Although it can affect individuals
of all ages, it is more commonly seen in young adult males.
⚠️ Causes and Risk Factors
Several factors contribute to the
development of ingrown toenails:
·
✂️
Improper nail trimming (rounding the corners instead of cutting straight
across)
·
👟 Wearing tight, narrow, or pointed footwear
·
🦶
Foot deformities
·
🤕
Trauma or repeated pressure on the toe
·
💦 Excessive sweating (hyperhidrosis)
·
🧬
Hereditary predisposition
·
Abnormal
nail shape or thickened nails
Understanding these risk factors
is essential for both prevention and effective management.
📊 Clinical Classification (Heifetz Staging)
Ingrown toenails are classified
into three stages according to the Heifetz classification, which helps guide treatment decisions:
Stage I – Mild
·
Pain
and redness
·
Minimal
swelling
·
No
infection
Stage II – Moderate
·
Increased
pain and swelling
·
Signs
of infection
·
Possible
discharge
Stage III – Severe
·
Chronic
inflammation
·
Granulation
tissue formation
·
Persistent
infection
Treatment is selected based on the
stage and severity of the condition.
🩺
Conservative (Non-Surgical) Management
Conservative treatment is
recommended for early-stage
(Stage I) cases and
aims to relieve symptoms while preventing progression.
General Measures:
·
👟 Wear comfortable, wide-toe footwear
·
✂️
Trim nails straight across (avoid rounding the corners)
·
🧼
Maintain proper foot hygiene
Symptom Relief:
·
🌊 Warm saline or antiseptic soaks several times daily
·
🧻
Placement of a small cotton wick, gauze, or plastic splint under the nail edge
to lift it away from the skin
·
💊 Topical or oral antibiotics if infection is present
Early intervention at this stage
often prevents the need for surgical procedures.
🔬 Surgical and Advanced Treatment Options
For recurrent, severe, or infected cases
(Stage II & III),
surgical management may be required.
✨ Chemical Matricectomy
This procedure destroys part of
the nail matrix to prevent recurrence using chemical agents such as:
·
Phenol
·
Sodium
hydroxide (NaOH)
·
Trichloroacetic
acid (TCA)
·
Silver
nitrate
🔪 Surgical Techniques
·
Winograd
technique (one of the
most commonly performed procedures)
·
Partial
nail avulsion
·
Electrocautery
·
Cryosurgery
·
CO₂
laser matricectomy
⚠️ Total
nail avulsion (complete nail removal) is rarely indicated and is reserved for
cases with severe nail deformity or extensive infection.
🏥 Postoperative Care
Proper postoperative care
significantly reduces complications and promotes healing.
Recommended measures include:
·
🩹
Aseptic dressing changes
·
👀 Regular wound monitoring
·
💊 Adequate pain control
·
🦶
Elevating the affected foot
·
👟 Wearing loose footwear
·
🧼
Maintaining good nail and foot hygiene
⚠️ Possible Complications
Although generally safe when
performed under sterile conditions by experienced practitioners, complications
may include:
·
🦠
Infection
·
🩸
Bleeding
·
Tissue
necrosis
·
Nail
deformity
·
Recurrence
Careful surgical technique and
patient adherence to postoperative instructions minimize these risks.
🎯 Conclusion
The management of ingrown toenail
requires a multidisciplinary
approach, including accurate
clinical staging, appropriate treatment selection, and thorough patient
education.
Early diagnosis and evidence-based
treatment protocols play a vital role in preventing complications, reducing
recurrence, and improving overall quality of life.
With proper care, patient
awareness, and timely intervention, ingrown toenails can be effectively treated
and prevented.
👩⚕️ About the Speaker
He is Y.Doruk Bilgili. He completed his medical
education at Demiroğlu Bilim University between 2009 and 2015. He completed my
residency in pediatric surgery at Zonguldak Bulent Ecevit University between
2016 and 2022. He worked at Siverek State Hospital and Bandirma Training and Research
Hospital between 2022 and 2024. He has been working as Head of Pediatric
Surgery Department at Bandirma Onyedi Eylul University since April 2024. He is
doing research on circumcision, perioperative anxiety and appendicitis.
🌍 Join the Global Conversation
Event:
International Conference on Pediatrics, Neonatology & Child Health
📅 March
26–28, 2026
📍 Singapore
& Online
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🔗 Register: https://pediatrics.miconferences.com/register
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Submission: https://pediatrics.miconferences.com/abstract-submission
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