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CC BY 4.0 · Arch Plast Surg 2023; 50(03): 274-278
DOI: 10.1055/a-2040-0721
Hand/Peripheral Nerve
Idea and Innovation

Toenail Paronychium Flap: Novel Surgical Approach for Ingrowing Toenail and Review of the Literature of Conventional Surgical Methods

Yujin Ahn 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
,
Hyunrok Lee 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
,
Surak Eo 
2   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Ilsan, Republic of Korea
,
Heakyeong Shin 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
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Abstract

Ingrown toenails are most common among school-age children and adolescents though they can be observed at any age. Causes of ingrown toenails are increased curvature, trauma, and external pressure. Treatment of ingrown toenails can be broadly characterized as conservative and surgical. Conservative treatment can be performed using various methods, such as a gutter splint, dental floss, and cotton. Surgical treatments may be divided into two main approaches; narrowing of the nail plate and debulking of periungual tissues. However, these various conservative and surgical treatments have high recurrence rates, and thus, the author used a permanent surgical method based on the use of a paronychium flap to treat a 15-year-old male adolescent with excessive periungual tissues and curved ingrown toenails who did not improve despite conservative and several surgical treatments over 4 years. Subsequently, toenail shape was maintained without recurrence 22 months after surgery, and there were no complaints of inflammation or pain while walking. This simple surgical method can be performed on patients with advanced ingrown toenails due to excessive periungual tissues and nail curvature and can be expected to have permanent effects.

Keywords

ingrown toenail - nail flap surgery - paronychium flap

Authors' Contributions

Study concept and design: Y.J.A. Data acquisition: Y.J.A. Drafting of the manuscript: Y.J.A., H.R.L. Critical revision of the manuscript for important intellectual content: E.S.R. Study supervision: H.K.S. Approval of final manuscript: all authors.


Ethical Approval

The study was approved by the Institutional Review Board of Dongguk University Hospital (IRB No.IRB;approval no.: 110757–202209-HR-03–02) and performed in accordance with the principles of the Declaration of Helsinki.


Patient Consent

The patient provided written informed consent for the publication and the use of his images.




Publication History

Received: 05 November 2022

Accepted: 15 February 2023

Accepted Manuscript online:
21 February 2023

Article published online:
29 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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