Chemical matricectomy with 10% sodium hydroxide for the treatment of ingrowing toenails

Background. In the last decades, phenol cauterization has been widely used with high success rates for the treatment of ingrowing toenails. However, unpredictable tissue damage and prolonged healing time are the disadvantages of this technique. Sodium hydroxide is an alternative chemical agent that causes less tissue damage. Objective. In this study, long-term results and postoperative morbidity of two sodium hydroxide chemical matricectomy procedures carried out by different application times have been investigated. Methods. A total of 156 partial chemical matricectomy procedures were performed with 10% sodium hydroxide in 60 patients divided into two groups. The first group (80 nail sides) received a 2-minute application of sodium hydroxide, whereas the second group (76 nail sides) received a combination of curettage of the lateral matrix area and 1-minute application of sodium hydroxide. Postoperative pain, drainage, and tissue damage were evaluated 2 days after the operation and at three more visits with weekly intervals. Long-term success rates of the methods were evaluated on the 6th month and at a further visit with a mean time of 16.83+/-2.18 months (range, 13 to 20). Results. Partial matricectomy with 10% sodium hydroxide was found to be 100% successful in both of the groups (P>0.05). Postoperative pain and tissue damage were either absent or minimal in the great majority of the patients with no statistical difference between the two groups (P>0.05). On the 2nd day, more patients in the first group experienced mild drainage than the patients in the second group (P=0.001), but in the following control visits, this difference disappeared. Conclusion. Matricectomy with 10% sodium hydroxide, either applied for 2 minutes or 1 minute combined with curettage, is equally effective in the treatment of ingrowing toenails with high success rates and minimal postoperative morbidity.