你知道外国人怎么治疗甲沟炎吗?一篇文章告诉你(附视频及文献原文)

国内对于甲沟炎的治疗手段有很多,医院一般都是采用手术治疗,而大部分的甲沟炎患者都是在修脚店处理了(鉴于以前医院都是全甲板拔出治疗,并不正规,现在还有很多医院在这样搞)。
那国外的医生都是怎么处理甲沟炎的呢?
今天我们结合一篇2020年发表在《J Cutan Aesthet Surg. 》文章跟大家聊一聊,文末有操作视频。

Abstract
Context:
Lateral plate avulsion with chemical matricectomy is the treatment of choice for ingrown toenails. Phenol is the most widely used cauterant, followed by 10% NaOH and more recently trichloroacetic acid.
Aims:
To evaluate the efficacy of 10% NaOH, 88% Phenol, and 90% TCA in cauterizing the matrix with regular follow up post surgery and clinical photographs.
Materials and Methods:
Fifteen adult patients presenting with ingrowing toe nails were recruited to the study with prior consent. The NaOH group (Group A) had five patients and five nails treated, the phenol group (Group B) had five patients and six nails treated, and the TCA group (Group C) had five patients and six nails treated. A total of 17 great toe nails were treated. Following proximal digital block and partial nail avulsion, the matrix was curetted and the lateral horn cauterized with 10% NaOH (1 min), 88% phenol (3 min), and 90% TCA (3 min). Post-procedure follow-up was done at weekly intervals to evaluate post-operative pain, oozing, and wound healing.
Statistical Analysis Used:
Graph pad prism software was used for statistical analysis. ANOVA tests were used to test the statistical significance between post-operative parameters of each group.
Results:
Mean duration of post-op pain in Group A was 4.2 days; Group B was 8.6 days, and Group C was 1.2 days. Oozing occurred for a mean duration of 10.6 days in Group A, 14 days in Group B, and 5.6 days in Group C. Mean duration of tissue re-epithelization was 28.4 days in Group A, 40.5 days in Group B, and 27.4 days in Group C.
Conclusions:
TCA is an effective cauterant for chemical matricectomy with the advantage of less duration of post-op pain and faster healing.
翻译:
摘要
背景:
外侧甲板切除联合化学基质切除术是治疗内生趾甲的首选方法。苯酚是最广泛使用的腐蚀剂,其次是10%的NaOH和最近的三氯乙酸。
目的:
评价10% NaOH, 88%苯酚,90% TCA(三氯乙酸)烧灼基质的效果,并定期随访术后和临床照片。
材料与方法:
15名趾甲向内生长的成年患者在事先同意的情况下被招募到研究中。NaOH组(A组)5例,5根指甲;苯酚组(B组)5例,6根指甲;TCA组(C组)5例,6根指甲。共治疗了17个大趾甲。在近端指块和部分甲撕脱后,将基质削平,外侧角用10% NaOH(1分钟)、88%苯酚(3分钟)和90% TCA(3分钟)烧灼。术后随访每星期进行一次,以评估术后疼痛、渗液和伤口愈合情况。
统计分析
采用graphpad prism软件进行统计分析。采用方差分析(ANOVA)检验各组术后参数之间的统计学意义。
结果:
A组术后疼痛平均持续时间4.2 d;B组8.6 d, C组1.2 d。渗脓的平均持续时间为a组10.6天,B组14天,C组5.6天。组织再上皮化的平均持续时间为a组28.4天,B组40.5天,C组27.4天。
结论:
TCA是一种有效的化学基质切除术的腐蚀剂,具有术后疼痛持续时间短,愈合快的优点。
Figure 1

Stage 1—ingrown nail with mild erythema and edema of nail folds; Stage 2—acute inflammation and suppuration; Stage 3—hypertrophy of nail folds with drainage and granulation tissue
Figure 2

Different steps in nail surgery
Figure 3

Pre- and post-operative results following TCA matricectomy
Figure 4

Pre- and post-operative results following NaOH matricectomy
Figure 5

Pre- and post-operative results following Phenol matricectomy
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实操视频:

文献原文:
最后编辑于 2024-04-06 · 浏览 1.8 万