Comparison of Partial Nail Avulsion With or Without Phenolization in the Management of Ingrown Toenails.

Background: Ingrown toenails, a common and often painful condition, frequently require surgical intervention for effective management. This study aimed to compare the clinical outcomes of partial nail avulsion (PNA) with and without adjunctive phenolization, specifically focusing on recurrence and postoperative wound infection rates.

Methods: This prospective comparative interventional study was conducted in the Department of General Surgery at Jinnah Hospital, Lahore, over a six-month period from July 15, 2023, to January 14, 2024. A total of 140 patients were included and randomly divided into two groups: 70 patients in Group A (PNA with phenolization) and 70 patients in Group B (PNA without phenolization). For categorical variables, statistical analysis was conducted using the chi-square test; a p-value of 0.05 was regarded statistically significant. To assess other influencing elements, a subgroup study by age and gender was carried out.

Results: Recurrence was significantly lower in Group A with one patient (1.43%) compared to seven patients (10.0%) in Group B (p=0.029). Wound infection was also reduced in Group A, occurring in four patients (5.71%) versus 12 patients (17.14%) in Group B (p=0.034). Among younger patients (12-35 years), recurrence was 0 out of 46 (0.0%) in Group A versus 6 out of 41 (14.63%) in Group B (p=0.007), while in older patients (36-60 years), recurrence rates were similar (4.17% vs. 3.45%; p=0.891). Female patients in Group A had no recurrence (0 out of 31; 0.0%) compared to 4 out of 32 (12.5%) in Group B (p=0.042).

Conclusions: Our findings indicate that PNA combined with phenolization offers superior outcomes in reducing recurrence rates, especially among younger and female patients, compared to PNA alone. While overall infection rates were lower with phenolization, stratified analysis did not consistently show statistical significance, and no notable adverse effects on wound healing were observed, supporting phenol's clinical utility with minor limitations.