“ARE WE TOE-ING THE LINE?” - OUTCOMES OF EIGHT YEARS OF PAEDIATRIC INGROWN TOENAIL SURGERY EXPLORED shermeenmore@gmail.com

 

“ARE WE TOE-ING THE LINE?” - OUTCOMES OF EIGHT YEARS OF PAEDIATRIC INGROWN TOENAIL SURGERY EXPLORED

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United Kingdom

Oral or Poster

The aim of this study was to analyse the outcomes of surgical management of ingrowing toenails (IGTN).

Retrospective review of medical records of patients, under 16 years, referred to a tertiary paediatric surgical hospital with IGTN, between 2016 and 2024. Wedge excisions (WE) or avulsions were performed as day-case surgery. Chi-square test used with p-value of < 0.05 considered as significant.

A total of 354 patients underwent 868 procedures. Mean age was 13 years (range 7 months- 16 years). Bilateral procedures were performed in 151/354. 45/354 underwent procedure under local anaesthesia, rest needed general anaesthesia. The lateral aspect was more affected than the medial in both toes: left (241;154), right (220;163). Figure 1. 140 patients had a follow up. 67/140 were asymptomatic. 27/140 reported post-op wound infections, requiring antibiotics. 18/27 were discharged without antibiotics. There was no significant association between the use of antibiotics and infection (p-value 0.48). 1/140 treated for bleeding. 84 recurrences (14 had prior avulsions) were documented in 45/354 patients. 71/84 recurrences were treated surgically. 48 new occurrences were reported in 34 patients. 45/48 were treated surgically.

Procedures for IGTN had high complication rates (52%). To improve patient-reported outcomes, a one-stop shop approach with surgical follow-ups at 7 days (infection) and 3 months (recurrences/ new occurrences) could be considered. This may reduce treatment delays by eliminating the need for GP visits and referrals. Furthermore, it is worth rationalizing the use of antibiotics, as there was no significant link between infection and the use of post-op antibiotics.