嵌甲所致慢性甲沟炎根治术

The surgical therapy for chronic paronychia caused by ingrown nail

目的探讨拔甲术联合甲床矫治术治疗因嵌甲所致的慢性甲沟炎的方法及疗效。方法以1%利多卡因于趾(指)神经阻滞麻醉,橡皮筋环扎趾(指)根部。先行拔甲术,然后行甲床矫治术,以患侧甲沟为中心作纵梭形切口,切除患侧趾甲沟皮肤、局部增生的炎性肉芽组织、甲沟旁软组织及相应甲床;间断推进缝合。结果93例患者中82例I期愈合,11例出现不同程度伤口感染,多次换药后痊愈。经3～20个月随访,88例效果良好,5例复发。结论拔甲术联合甲床矫治术治疗慢性甲沟炎创伤较小,针对嵌甲所致慢性甲沟炎的病理解剖特点而设计,治愈率高,预后较好,值得推广。

Objective To study the operation approach and evaluate the effect of nail extraction combined with nail bed diorthosis for chronic paronychia caused by ingrown nail.Methods The nail was extracted after a digital nerve block was performed and the base of the digit was bound up.Then a fusiform incision was made around the nail groove in the abnormal side.The skin,hyperplastic inflammatory granulation tissue,soft tissue beside the nail groove,the ingrown segment of the nail plate and its corresponding nail bed were ectomized.Finally the incision was interrupted suturated with advanced skin flap.Results In the total 93 patients,82 patients got primary healing,11 patients developed surgical wound infection and healed after dressing changes.The 12-month follow-up data showed good results,most of the patients recovered,only 5 patients recured.Conclusion Nail extraction combined with nail bed diorthosis is an approach which is desinged according to the anatomicopathological character of chronic paronychia caused by ingrown nail.This approach deserves generalization because its little trauma and high cure rate.