Comparison between Knot and Winograd techniques on ingrown nail treatment

Abstract

Objective: The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This study also aimed to determine the etiology of ingrown nails, whether due to involvement of the nail or soft tissue.
Methods: Seventy-five patients with a total of 90 ingrown nails (stages 2 and 3) who presented at our clinic between 2012 and 2014 were included in this study. Patients were divided into 2 groups: those treated with the knot technique and those treated with the Winograd technique. Patients in both groups were evaluated for the amount of local anesthetic required, intra-operative pain, effectiveness of preventing/stopping hemorrhage, surgery time, complications, postoperative nail sizes, recurrence, nail deformities, and secondary surgery rates.
Results: The mean surgical time, relapse rate, number of additional surgeries required, and amount of local anesthetic were significantly greater in Winograd Group  than in knot Group. The mean nail diameter was significantly decreased, with a mean of 3 mm in Winograd Group. No statistically significant differences were found between groups in the incidence of infection, intra-operative pain, hematoma, or nail deformity.
Conclusion: This study demonstrated that the knot technique, consisting of wedge excision of soft tissue without affecting the nail itself, is a simple technique to treat ingrown nails with a lower complication rate and shorter surgical time. We believe that successful treatment of ingrown nails depends only on excision of soft tissue with no need to operate on the nail bed.