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CORRESPONDENCE • An. Bras. Dermatol. 96 (05) • 2021 • https://doi.org/10.1016/j.abd.2021.05.003   copy

On the development of surgical techniques for the treatment of onychocryptosis - Answer☆ ☆ How to cite this article: Ma H. On the development of surgical techniques for the treatment of onychocryptosis - Answer. An Bras Dermatol. 2021;96:653. ,☆☆ ☆☆ Study conducted at the Department of Dermatology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Província de Guangdong, China.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Dear Editor,

I am very pleased with the attention given to my article11 Man H. Six steps to standardize surgical approach for ingrown toenail. An Bras Dermatol. 2021;96:47-50.. As mentioned in the table of the correspondence,22 Miola AC, Alcantara GP, Miot LDB, Miot HA. Considerations on the development of surgical techniques for the treatment of onychocryptosis. An Bras Dermatol. 2021;96:651-3. there are numerous surgical techniques for onychocryptosis. In the first paragraph of my article, I have cited the literature33 Richert B. Surgical management of ingrown toenails - an update overdue. Dermatol Ther. 2012;25:498-509. to emphasize that all the surgical strategies can be categorized into two main approaches: either narrowing the nail plate or debulking the soft tissues. And I have chosen the first one.

The key point to narrow the nail plate is to destroy the corresponding part of the nail matrix completely. Treatments include surgery, electrocautery, and chemicals, etc. The most assured is the surgical excision. There are clear points and lines of reference in every step of the surgical approach I proposed. In the discussion, I emphasized that Step 4 is the most important procedure to avoid recurrence. I was very careful to cut off all the tissue around the corresponding part of the nail matrix in all my 67 patients. And there are still two suggestions: 1) to see the white phalanx; 2) to perform a little wedge-shaped resection. As a result, I am very confident to guarantee low recurrence or even no recurrence after surgery.

I have propagated my technique in more than fifteen hospitals in southern China. Most dermatologists only need to observe and listen once to achieve results similar to mine. Even so, with the established method, there may be a few differences in the final recurrence rate among different doctors.

  • Financial support
    This was supported by Zhuhai Science and Technology Plan Medical and Health Project (ZH2202200003HJL).

References

  • 1
    Man H. Six steps to standardize surgical approach for ingrown toenail. An Bras Dermatol. 2021;96:47-50.
  • 2
    Miola AC, Alcantara GP, Miot LDB, Miot HA. Considerations on the development of surgical techniques for the treatment of onychocryptosis. An Bras Dermatol. 2021;96:651-3.
  • 3
    Richert B. Surgical management of ingrown toenails - an update overdue. Dermatol Ther. 2012;25:498-509.

Publication Dates

  • Publication in this collection
    18 Oct 2021
  • Date of issue
    2021

History

  • Received
    30 Apr 2021
  • Accepted
    4 May 2021
  • Published
    15 July 2021
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