Use of phenol in ingrown nail surgery

Ingrown nails can be troublesome and in case of pronounced problems, you sometimes need to remove part of the nail under local anesthesia. To prevent the removed part of the nail from growing back and again causing problems, phenol is applied to the nail layer, which causes it to regress. Phenol is highly corrosive and toxic.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

Question

What scientific studies have been published regarding the positive and negative effects of the use of phenol in ingrown nail surgery?

Method

A systematic literature search was performed using the following databases: Medline and SCOPUS.

Two authors independently assessed the abstracts of all identified studies.
Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature

In two relevant systematic reviews, the risk of bias was considered to be high, therefore the results and conclusions are not reported [1, 2]. In addition, five relevant primary studies were identified [3-7]. Primary studies are not assessed for risk for bias.

References

  1. Chang HC, Lin MH. Comparison of Chemical Matricectomy with Trichloroacetic Acid, Phenol, or Sodium Hydroxide for Ingrown Toenails: A Systematic Review and Network Meta-Analysis. Acta Derm Venereol. 2020;100(4):adv00065. Available from: https://doi.org/10.2340/00015555-3379.
  2. Vinay K, Narayan Ravivarma V, Thakur V, Choudhary R, Narang T, Dogra S, et al. Efficacy and safety of phenol-based partial matricectomy in treatment of onychocryptosis: A systematic review and meta-analysis. Journal of the European Academy of Dermatology & Venereology. 2022;36(4):526-35. Available from: https://doi.org/10.1111/jdv.17871.
  3. Bostanci S, Kocyigit P, Gurgey E. Comparison of phenol and sodium hydroxide chemical matricectomies for the treatment of ingrowing toenails. Dermatol Surg. 2007;33(6):680-5. Available from: https://doi.org/10.1111/j.1524-4725.2007.33143.x.
  4. Grover C, Khurana A, Bhattacharya SN, Sharma A. Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail. Indian J Dermatol Venereol Leprol. 2015;81(5):472-7. Available from: https://doi.org/10.4103/0378-6323.163787.
  5. Andre MS, Caucanas M, Andre J, Richert B. Treatment of Ingrowing Toenails With Phenol 88% or Trichloroacetic Acid 100%: A Comparative, Prospective, Randomized, Double-Blind Study. Dermatologic Surgery. 2018;44(5):645-50. Available from: https://doi.org/10.1097/DSS.0000000000001499.
  6. Ahsan MF, Irshad A, Asif M, Zafar M, Shah SA. Comparison of trichloroacetic acid and phenol application after partial nail extraction in the treatment of ingrown toe nails. Pakistan Journal of Medical and Health Sciences. 2019;13(4):982-4.
  7. Ramesh S, Shenoi S, Nayak S. Comparative efficacy of 10% sodium hydroxide, 88% phenol, and 90% trichloroacetic acid as chemical cauterants for partial matricectomy in the management of great toe nail onychocryptosis. Journal of Cutaneous and Aesthetic Surgery. 2020;13(4):314-8. Available from: https://pubmed.ncbi.nlm.nih.gov/33911412/.
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Published: Report no: ut202318 Registration no: SBU 2023/196
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Search strategies

Medline via OvidSP 27 April 2023

Title: Usage of phenol in ingrown nail surgery
* Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity- and precision-maximizing version (2008 revision); Ovid format. The Cochrane Collaboration; 2008. Available from: https://training.cochrane.org/handbook/current/chapter-04-technical-supplement-searching-and-selecting-studies#section-3-6-1. with modifications: the following terms are added: clinical trial, phase iii.pt. ; randomised.ab. ; ("Phase 3" or "phase3" or "phase III" or P3 or "PIII").ti,ab,kw.

/ = Term from the MeSH controlled vocabulary; .sh = Term from the MeSH controlled vocabulary; exp = Term from MeSH including terms found below this term in the MeSH hierarchy; .ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords; .kw = Keywords, exact; .bt = Book title. NLM Bookshelf.; .pt = Publication type; .ja = Journal abbreviation; .af = All fields; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other.; * or $ = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. exp Nails, Ingrown/ OR (((ingrown OR ingrowth OR in-grown) adj3 (nail OR nails OR toenail OR toenails)) OR Onychocryptosis OR Onychocryptoses OR retronychia).af. 1057
Intervention:
2. exp Phenol/ OR (phenol OR phenolization or phenolisation or "chemical matricectomy").af. 39942
Study types: systematic reviews and meta-analysis / randomized controlled trials*
3. ((Systematic Review/ or Meta-Analysis/ or Cochrane Database Syst Rev.ja. or ((systematic adj4 review) or "meta analys*" or metaanalys*).ti,bt,ab.) not (editorial/ or letter/ or case reports/)) 426877
4. (randomized controlled trial.pt. OR controlled clinical trial.pt. OR clinical trial, phase iii.pt. OR ((randomized or randomised).ab.) OR placebo.ab. OR clinical trials as topic.sh. OR randomly.ab. OR trial.ti. OR (("Phase 3" or "phase3" or "phase III" or P3 or "PIII").ti,ab,kw.)) NOT (exp animals/ not humans.sh.) 1481504
Combined sets:
5. 1 AND 3 10
6. 1 AND 4 84
7. 1 AND 2 158
Final result
8. 5 OR 6 OR 7 200

Scopus via scopus.com 27 April 2023

Title: Usage of phenol in ingrown nail surgery
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields; W/n = Within. Proximity operator retrieving terms within n words from each other.; PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words.; LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range.; DOCTYPE = Publication type; “re” = review; “le” = letter; “ed” = editorial; “ch” = book chapter; “cp” = conference proceedings; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. ( TITLE-ABS-KEY ( ( ( ingrown OR ingrowth OR in-grown ) W/3 ( nail OR nails OR toenail OR toenails ) ) OR onychocryptosis OR onychocryptoses OR retronychia ) ) 1577
Intervention
2. TITLE-ABS-KEY ( phenol OR phenolization OR phenolisation OR "chemical matricectomy" ) 280291
Study types: systematic reviews and meta-analysis / randomized controlled trials
3. TITLE-ABS-KEY ( ( systematic W/2 review ) OR "meta analy*" OR metaanaly* ) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “ch”) OR EXCLUDE (DOCTYPE, “cp”)) 623178
4. INDEXTERMS ( "clinical trials as a topic" OR "Randomized Controlled Trials as Topic" OR "multicenter study" OR "double blind procedure" OR "single blind procedure" OR "crossover procedure" OR "clinical trial" OR "controlled study" OR "randomization" OR "placebo" ) OR TITLE-ABS-KEY ( "clinical trials" OR "randomized controlled trial" OR "randomized controlled trials" OR "controlled clinical trial" OR "controlled clinical trials" OR "random allocation" OR "randomly allocated" OR "allocated randomly" OR "Double-Blind Method" OR "single-blind method" OR "cross-over studies" OR placebo* OR "cross-over trial" OR "single blind" OR "double blind" OR "factorial design" OR "factorial trial" ) OR TITLE ( trial* OR rct OR randomised* OR randomized* ) 9102062
Combined sets:
5. 1 AND 3 17
6. 1 AND 4 265
7. 1 AND 2 216
Final result
8. 5 OR 6 OR 7 395
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