Dermatology: Practical and Conceptual Original Article | Dermatol Pract Concept. 2025;15(2):4883 1 Long-Term Outcomes of Surgical and Chemical Matricectomy for Ingrown Toenail Management: A Retrospective Study Ayda Acar1, Ayris Ozturk2, Berke Kokluce1, Bengu Gerceker Turk3, Tugrul Dereli4 1 Ege University Medical Faculty, Department of Dermatology and Venereology, Izmir 2 Usak Training and Research Hospital, Usak 3 Special office, İzmir 4 Special office, İzmir Key words: Ingrown toenail, Matricectomy, Surgical matricectomy, Chemical matricectomy, Recurrence of ingrown toenail Citation: Acar A, Ozturk A, Kokluce B, Turk BG, Dereli T. Long-Term Outcomes of Surgical and Chemical Matricectomy for Ingrown Toenail Management: A Retrospective Study. Dermatol Pract Concept. 2025;15(2):4883. DOI: https://DOI.org/10.5826/dpc.1502a4883 Accepted: December 11, 2024; Published: April 2025 Copyright: ©2025 Acar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Berke Kokluce, MD. Department of Dermatology, Ege University Faculty of Medicine, University Street no:9, 35100 Bornova/Izmir/Turkey. ORCID ID: 0000-0002-8497-742X. E-mail: berkekokluce@gmail.com, berke.kokluce@ege.edu.tr Introduction: Matricectomy is an effective treatment method for ingrown toenails. Objectives: This study aimed to evaluate the outcomes of matricectomy procedures for ingrown toenails at a dermatology clinic, focusing on patient characteristics, recurrence rates, post-operative complications, and patient satisfaction. Methods: Patient records from 2009 to 2023 for those undergoing surgical or chemical matricectomy for ingrown toenails in the dermatological surgery unit were retrospectively reviewed. Results: The study analyzed 300 matricectomies performed on 164 patients. Chemical matricectomy was performed on 97.6% (160 patients), while 2.4% (4 patients) underwent surgical matricectomy alone, and 20.7% (34 patients) received both surgical and chemical matricectomy. Healing times and prolonged pain showed no significant differences between surgical, sodium hydroxide, and phenol matricectomy. No significant relationship was identified between side effect development and factors such as diabetes mellitus, previous nail procedures, or the type of matricectomy (surgical, phenol, or sodium hydroxide). Recurrence rates ranked from lowest to highest as follows: combined surgical and chemical, sodium hydroxide, and phenol matricectomy; however, these differences were not statisti- cally significant. Conclusions: No significant difference was observed in recurrence rates, side effects, or patient satis- faction between surgical, sodium hydroxide, and phenol matricectomy procedures. ABSTRACT 2 Original Article | Dermatol Pract Concept. 2025;15(2):4883 Introduction Ingrown toenail, or onychocryptosis, is a painful condition that significantly impacts an individual's quality of life. This condition occurs when the nail plate grows into the periun- gual skin, accounting for approximately 20% of foot-related visits to family physicians [1]. It most commonly affects the lateral side of the big toenail, with a prevalence of 2.5% to 5% in the general population [2,3]. Contributing factors in- clude trauma, improper nail cutting, hyperhidrosis, inappro- priate footwear, congenital hypertrophic periungual folds, diabetes mellitus (DM), and obesity [4,5]. Ingrown toenails are classified into stages based on severity. The first stage (mild) is characterized by pain upon touch, redness, and swelling. The second stage (moderate) includes seropurulent discharge and infection. The third stage (severe) is marked by granulation tissue formation and hypertrophy of the nail fold [6]. Conservative treatments like cotton placement and toenail braces are effective for non-severe ingrown toenails. For recurrent and severe cases, treatment options include chemical matricectomy, surgery, electrocautery, cryosurgery, and CO2 laser matricectomy. Chemical matricectomy in- volves the use of active agents such as phenol, sodium hy- droxide (NaOH), trichloroacetic acid (TCA), or silver nitrate [6]. Phenol and NaOH are the most commonly used agents, with phenol causing coagulation necrosis and NaOH induc- ing liquefaction necrosis [7]. Although phenol is the gold standard for chemical matricectomy, its drawbacks include toxicity and unsuitability during pregnancy [8,9]. The typi- cal concentration used for phenol in matricectomy is 88%, while NaOH is used at a 10% concentration [4,7]. Stud- ies have explored various application durations. NaOH is neutralized with acetic acid post-application, while phenol is diluted with alcohol as it cannot be fully neutralized [10]. Objectives This study aimed to compare the outcomes of phenol, NaOH, and surgical matricectomy procedures. Methods This study included patients treated for ingrown toenails at the Department of Dermatology and Venereal Diseases, Ege University Medical Faculty, between 2009 and 2023. These patients underwent either surgical or chemical ma- tricectomy (using phenol or NaOH) in the dermatological surgery unit. Surgical procedures involved wedge resection for patients treated surgically alone, while combined therapy with chemical cauterization included curettage. Before the procedure, patients were prescribed topical treatments such as antiseptics, fusidic acid, or mupirocin cream for one week, if suspected infection was present. After the procedure, pa- tients were prescribed oral amoxicillin and clavulanic acid, along with topical antiseptics. All patients were scheduled for follow-up visits after the matricectomy. Demographic data, ingrown toenail stage before the procedure, procedure type, side effects, and recurrence rates were retrospectively analyzed from patient records. Post-procedure satisfaction was assessed through telephone interviews. The study was approved by the Local Ethics Committee protocol no: 23- 8T/27. IBM SPSS Statistics 25.0 (IBM Corp; Armonk, NY) was used for data analysis. The normality of numerical vari- ables was examined using the Shapiro-Wilk test (for N<50) and the Kolmogorov-Smirnov test (for N≥50). Numerical variables are expressed as mean ± standard deviation and median (range). The Mann-Whitney U test was used to compare numerical variables that did not follow a normal distribution. Categorical variables are presented as counts and percentages. Relationships between categorical variables were analyzed using the Pearson Chi-squared test or Fisher's exact test, as appropriate. A significance level of 0.05 was considered for all hypotheses. Results The study analyzed 300 matricectomies performed on 164 patients. Of these patients, 53% were female, with a mean age of 31±15.5 (10-85) years. The mean duration of ingrown toenails was 4.7±5.9 years (range: 0.08–30). Co- morbidities were present in 30 patients (18.3%), including DM, hypertension, neurological disorders, circulatory is- sues, and orthopedic conditions. DM was present in four patients (2.4%). Five patients (3%) had a history of sur- gery on the same toenail, while another five patients (3%) had pincer nails. Of the patients with documented ingrown toenail stages, seven (4.2%) had stage 1, 52 (31.7%) had stage 2, and 76 (47.5%) had stage 3. The right foot was treated in 107 patients, the left foot in 105, and both feet in 48 (29.2%). All the matricectomies were performed on the big toe. Regarding the number of matricectomies, 72 pa- tients (43.9%) underwent one procedure, 68 (41.5%) had two, four (2.4%) had three, and 20 (12.2%) had four proce- dures. Chemical matricectomy (Figure 1) was performed on 97.6 % (160) of the 164 patients; of these, 103 patients (62.8%) received NaOH monotherapy, 23 (14.0%) under- went phenol monotherapy, 32 (19.5%) were treated with surgical intervention combined with phenol, and two (1.2%) with surgical intervention combined with NaOH. Four pa- tients (2.44%) underwent surgical matricectomy alone. For 54 patients with available healing time data, the median healing time was 14.5 days (range: 10–90). Median healing times were as follows: 14.5 days (range: 10–42, N=36) for NaOH monotherapy, 17.5 days (range: 10–28, Original Article | Dermatol Pract Concept. 2025;15(2):4883 3 N=4) for phenol monotherapy, 14 days (N=2) for surgical intervention alone, 59 days (range: 28–90, N=2) for surgical intervention combined with NaOH, and 17.5 days (range: 10–30, N=10) for surgical intervention combined with phe- nol. However, statistical analysis showed no significant dif- ference in healing time between NaOH monotherapy, phenol monotherapy, surgical intervention with NaOH, and surgical intervention with phenol (P: 0.35). Of the 55 patients with available post-procedure satisfaction data, eight (14.5%) were dissatisfied with the outcomes. Among these, seven pa- tients (17.9%) were dissatisfied after NaOH application, and one patient (7.1%) was dissatisfied after surgical interven- tion with phenol. However, these differences were not statis- tically significant (P> 0.05). Of the 54 patients with available data, 10 (18.5%) reported prolonged pain: seven (12.9%) in the NaOH group, one (1.8%) in the phenol group, one (1.8%) in the surgery+phenol group, and one (1.8%) in the surgery alone group. These differences were not statistically significant (P>0.05). Of the 57 patients with available data, eight (14%) reported developing side effects. Specifically, six patients (10.5%) developed secondary infections, and two (3.5%) experienced prolonged serous discharge. No signif- icant relationship was identified between side effect devel- opment and comorbid conditions, previous nail procedures, or the type of matricectomy performed (P>0.05). Of the 63 patients (116 matricectomies) with available data, recur- rence occurred in 22 matricectomies (18.96%) among 17 pa- tients. For patients with known recurrence status, the mean follow-up duration was 104 months (range: 12–196). The mean time to recurrence was 1.6±1.7 years. Recurrence rates by procedure were as follows: combined surgical and chemi- cal matricectomy–18.8%, NaOH matricectomy–25.6%, and phenol matricectomy–33%. However, these differences were not statistically significant (P>0.05). No significant relation- ship was identified between recurrence and sex, comorbid conditions, previous nail procedures, or the type of matricec- tomy (P>0.05). Results are summarized in Table 1. Conclusions This study evaluated the outcomes of 300 matricectomy procedures performed on 164 patients. While previous studies often report a higher prevalence of ingrown toenails among males, others have noted a greater prevalence among females, similar to our findings [8,10-12]. A 2020 review reported that female representation in ingrown toenail treat- ment studies ranged from 34.4% to 90% [2]. Two different reviews reported average patient ages ranging from 13.5 to 51.2 and 16.1 to 41.4, respectively [2, 8], aligning with the mean age of 31 ± 15.5 years observed in our study. Addi- tionally, consistent with Delgado-Miguel et al. and Yang et al., the lateral side of the big toe was the most commonly affected site [6, 13]. In this study, we analyzed 300 procedures performed on 164 patients, with recurrence data available for 116 matricectomies in 63 patients; recurrence occurred in 22 matricectomies among 17 patients (18.9%), with a mean time to recurrence of 1.6 ± 1.7 years. Recurrence rates and follow-up durations for matricectomies using chemical, sur- gical, electrocautery, and carbon dioxide laser methods, as reported in the literature, are summarized in Table 2. These rates range from 0% to 48.3% [3-6,10-13,14-21]. Factors such as the treatment method, practitioner experience, and follow-up duration can influence recurrence rates. While some studies did not specify follow-up periods, others re- ported durations ranging from three to 66 months. In our study, patients with known recurrence data had a mean follow-up duration of 104 months (range: 12–196 months). The extended follow-up in our study may have contributed to the higher recurrence rate observed. Consistent with our findings, a 2012 Cochrane analysis suggested that combin- ing surgical and chemical matricectomy reduces recurrence risk compared to surgical matricectomy alone, particularly when phenol was used [1]. Similarly, a 2021 meta-analysis by Vinay et al. identified phenol matricectomy as having a lower Figure 1. Appearance of the nail unit of patient who underwent NaOH matricectomy (A) before and (B) after recovery. 4 Original Article | Dermatol Pract Concept. 2025;15(2):4883 Table 1. Outcomes of Nail Matricectomy Procedures. Category Subcategory Details Results Patient Demographics Sex Female 53% (87 patients) Male 47% (77 patients) Age Mean ± SD, Range 31 ± 15.5 years (10–85 years) Duration of symptoms Mean ± SD, Range 4.7 ± 5.9 years (0.08–30 years) Comorbidities Patients with any comorbidity 18.3% (30 patients) Patients with DM 2.4% (4 patients) History of surgery on the same toenail Patients with previous surgery 3% (5 patients) Pincer Nails Patients with pincer nails 3% (5 patients) Ingrown Toenail Stages Stage 1 4.2% (7 patients) Stage 2 31.7% (52 patients) Stage 3 47.5% (76 patients) Procedural Characteristics Treated Foot Right foot 65.2% (107 patients) Left foot 63.4% (105 patients) Both feet 29.2% (48 patients) Number of Matricectomies 1 procedure 43.9% (72 patients) 2 procedures 41.5% (68 patients) 3 procedures 2.4% (4 patients) 4 procedures 12.2% (20 patients) Procedure Type NaOH monotherapy 62.8% (103 patients) Phenol monotherapy 14% (23 patients) Surgical+Phenol 19.5% (32 patients) Surgical+NaOH 1.2% (2 patients) Surgical only 2.4% (4 patients) Healing Times Overall Median ± Range 14.5 days (10–90 days) By Procedure NaOH monotherapy 14.5 days (10–42 days, n = 36) Phenol monotherapy 17.5 days (10–28 days, n = 4) Surgical only 14 days (n = 2) Surgical+NaOH 59 days (28–90 days, n = 2) Surgical+Phenol 17.5 days (10–30 days, n = 10) Patient Satisfaction Dissatisfaction Rate Overall dissatisfaction 14.5% (8 patients) Dissatisfied after NaOH 17.9% (7 patients) Dissatisfied after Surgical+Phenol 7.1% (1 patient) Prolonged Pain Overall Patients reporting prolonged pain 18.5% (10 patients) By Procedure NaOH 12.9% (7 patients) Phenol 1.8% (1 patient) Surgical only 1.8% (1 patient) Surgical+Phenol 1.8% (1 patient) Side Effects Incidence Patients reporting side effects 14% (8 patients) Secondary infections 10.5% (6 patients) Prolonged serous discharge 3.5% (2 patients) Recurrence Overall Recurrence rate 18.96% (22 of 116 matricectomies) Time to Recurrence Mean ± SD 1.6 ± 1.7 years By Procedure Combined surgical and chemical matricectomy 18.8% (3 patients) NaOH monotherapy 25.6% (20 patients) Phenol monotherapy 33% (9 patients) Original Article | Dermatol Pract Concept. 2025;15(2):4883 5 procedures, or the type of matricectomy performed. Postop- erative infections, the most common complication following matricectomy, have been reported in the literature with rates ranging from 0.46% to 18.9% [5,13,15,9,20,22] (Table 3). The infection rates in our study fall within this range, consis- tent with previously reported outcomes. Similar to our find- ings, Yang et al. reported no significant association between infection risk and the procedural methods [13]. Rusmir et al. attributed higher infection rates after matricectomy, com- pared to other clean foot and ankle surgeries, to microbial colonization on the nail fold [22]. A Cochrane review further emphasized the lack of evidence supporting routine postop- erative antibiotic use to prevent infections [1]. Consistent with previous studies, phenol matricectomy appears to of- fer faster recovery times compared to NaOH and surgical recurrence risk compared to other chemical matricectomies, destructive methods, and conservative treatments [8]. In ad- dition, Ozdemir et al. reported no recurrence with chemical matricectomy using NaOH [10]. Gurhan et al. noted that adding electrocautery to wedge resection reduced recurrence in adolescents but had no significant effect in adults [11]. In a study of pediatric patients, Yang et al. found a signifi- cant reduction in recurrence risk with preoperative antibiotic use and chemical matricectomy. They noted no association between recurrence risk and factors such as sex, duration of ingrown toenail, laterality, preoperative inflammation, or anesthesia type [13]. Misiak et al. reported that the absence of comorbidities was associated with a lower recurrence risk [3]. Similarly, recurrence rates in our study were not signifi- cantly associated with comorbid conditions, previous nail Table 2. Summary of Matricectomy Method, Number of Procedures, Recurrence Rate, and Follow-Up Periods of the Studies in the Literature [3-6, 10-13, 14-21]. Author Matricectomy Procedure Number of Matricectomies Recurrence Rate (%) Follow-Up Duration (Months) Andreassi et al. (14) Phenol 948 4.3 18 Ozdemir et al. (10) NaOH 156 0 16.83±2.18 (13-20) Romero-Pérez et al. (15) Phenol 191 17.8 Up to 66 Surgical 329 8.2 Misiak et al. (3) Phenol 30 16.67 3 Electrocautery 30 26.67 Bostanci et al. (4) Phenol 350 0.57 25 Mitchell et al. (12) Phenol 87 18.4 14 Nail bed excision 31 22.6 Wedge resection 180 48.3 Wedge resection + phenol 344 21.2 Córdoba-Fernández et al. (16) Wedge resection + phenol 74 7.4 40.8 (34-51) Barreiros et al. (17) TCA 197 2 6 Sargin et al. (18) Winograd 61 14.7 3 Winograd + electrocautery 82 3.6 Delgado-Miguel et al. (6) Electrocautery 86 11.2 Silver nitrate 151 4.7 Yang et al. (13) Avulsion + curettage 22 19 Avulsion + surgical matricectomy 420 20 Avulsion + chemical matricectomy 112 12 Gurhan et al. (11) Wedge resection 96 14 12.35 Wedge resection + electrocautery 93 9 Farley-Sakevich et al. (19) Co2 Laser 381 2.1 34 (min 12) Kim et al. (20) Winograd + electrocautery 76 3.95 14.66 (12-25) Kayalar et al. (21) Winograd 480 9.8 36 (10-100) Wang et al. (5) Original minimal invasive method 436 1.6 >24 6 Original Article | Dermatol Pract Concept. 2025;15(2):4883 3. Misiak P, Terlecki A, Rzepkowska-Misiak B, Wcisło S, Brocki M. Comparison of effectiveness of electrocautery and phenol appli- cation in partial matricectomy after partial nail extraction in the treatment of ingrown nails. Pol Przegl Chir. 2014;86(2):89-93. DOI: 10.2478/pjs-2014-0016 PMID: 24670340. 4. Bostanci S, Ekmekçi P, Gürgey E. Chemical matricectomy with phenol for the treatment of ingrowing toenail: a review of the lit- erature and follow-up of 172 treated patients. Acta Derm Vene- reol. 2001;81(3):181-183. DOI: 10.1080/000155501750376267 PMID: 11558873. 5. Wang Y, Zhang N, Li X, et al. A novel cosmetic approach for partial matricectomy in treating ingrown toenails.  J Cosmet Dermatol. 2023;22(9):2542-2547. DOI: 10.1111/jocd.15762 PMID: 37128829. 6. Delgado-Miguel C, Muñoz-Serrano AJ, Moratilla L, Sarmiento MDC, Miguel-Ferrero M, Martínez L. The effectiveness of ma- trix ablation with silver nitrate in the treatment of ingrown toenails. A single-center case-control study.  Pediatr Dermatol. 2023;40(2):282-287. DOI:10.1111/pde.15217 PMID: 36461609. 7. Bostancı S, Koçyiğit P, Güngör HK, Parlak N. Complications of sodium hydroxide chemical matrixectomy: nail dystrophy, allodynia, hyperalgesia. J Am Podiatr Med Assoc. 2014;104(6): 649-651. DOI: 10.7547/8750-7315-104.6.649 PMID: 25514278. 8. Vinay K, Narayan Ravivarma V, Thakur V, et al. Efficacy and safety of phenol-based partial matricectomy in treatment of onychocryptosis: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2022;36(4):526-535. DOI: 10.1111 /jdv.17871 PMID: 34913204. 9. 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 Feb 27;100(4):adv00065. DOI: 10.2340/00015555-3379. PMID: 31776585. 10. Ozdemir E, Bostanci S, Ekmekci P, Gurgey E. Chemical matricec- tomy with 10% sodium hydroxide for the treatment of ingrow- ing toenails.  Dermatol Surg. 2004;30(1):26-31. DOI: 10.1111 /j.1524-4725.2004.30004.x PMID: 14692922. 11. Gurhan U, Kahve Y, Yavuz IA, Varol A, Erler K. Does Electrocau- terization of the Matrix After the Wedge Resection of the Toe- Nail Affect Recurrence in Discrete Age Groups Differently? A Retrospective Analysis. J Foot Ankle Surg. 2023;62(2):291-294. DOI: 10.1053/j.jfas.2022.08.002 PMID: 36182645. 12. Mitchell S, Jackson CR, Wilson-Storey D. Surgical treatment of ingrown toenails in children: what is best practice? Ann R Coll methods, though our findings did not show a statistical sig- nificance. Misiak et al. reported faster healing with phenol matricectomy compared to electrocautery [3]. Bostanci et al. indicated a healing time ranging from two to four weeks [4]. Surgical and chemical matricectomy are both effective treatments for ingrown toenails. The recurrence rates ob- served in this study may have been influenced by the extended follow-up period and difficulties in reaching all patients. Fac- tors such as non-attendance at follow-up appointments by pa- tients without recurrence and additional treatment sought by those with recurrence could have contributed to these findings. Furthermore, shorter application times for chemical agents during matricectomy may have impacted the outcomes. No- tably, our study found no significant difference in recurrence rates, side effect development, or patient satisfaction among surgical, NaOH, and phenol matricectomy procedures, under- scoring the comparable efficacy of these treatment methods. Limitations This study is limited by missing patient data, primarily due to its retrospective design spanning 2009–2023. Incomplete documentation from earlier years and difficulties in reaching patients for post-procedure satisfaction assessments contrib- uted to data gaps. Despite multiple attempts, some patients were unreachable due to outdated contact information. These challenges impacted the dataset for 164 patients and 300 matricectomies, potentially limiting the comprehensive- ness of the analysis. References 1. Eekhof JA, Van Wijk B, Knuistingh Neven A, van der Wouden JC. Interventions for ingrowing toenails.  Cochrane Database Syst Rev. 2012;2012(4):CD001541. Published 2012 Apr 18. DOI: 10.1002/14651858.CD001541.pub3 PMID: 22513901. 2. Stewart CR, Algu L, Kamran R, et al. Patient Satisfaction with Treatment for Onychocryptosis: A Systematic Review. Skin Ap- pendage Disord. 2020;6(5):272-279. DOI: 10.1159/000508927 PMID: 33088811. Table 3. Summary of Studies in the Literature Reporting Post-Operative Infection After Matricectomy [5,13,15,19,20,22]. Author Matricectomy Procedure N. of Matricectomies Rate of Post-Operative Infection (%) Rusmir et al. (22) Excisional matricectomy 111 18.9 Yang et al. (13) Surgical matricectomy 383 6 Farley-Sakevich et al. (19) CO2 laser 381 6.6 Kim et al. (20) Winograd + matrix electrocauterization 76 2.63 Romero-Pérez et al. (15) Surgical matricectomy 329 15.3 Chemical matricectomy 191 2.9 Wang et al. (5) Original minimal invasive method 436 0.46 Original Article | Dermatol Pract Concept. 2025;15(2):4883 7 18. Sargin S, Gulcu A, Aslan A. Does the Type of Surgical Technique and the Use of Prophylactic Antibiotics Affect the Clinical Results in Symptomatic Ingrown Toenail Pa- tients?. Int J Low Extrem Wounds. 2024;23(1):124-132. DOI: 10.1177/15347346211043602 PMID: 34515568. 19. Farley-Sakevich T, Grady JF, Zager E, Axe TM. Onychoplasty with carbon dioxide laser matrixectomy for treatment of in- grown toenails. J Am Podiatr Med Assoc. 2005;95(2):175-179. DOI: 10.7547/0950175 PMID: 15778478. 20. Kim J, Lee S, Lee JS, et al. A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure. Int J Environ Res Public Health. 2021;18(1):278. Published 2021 Jan 1. DOI: 10.3390/ijerph18010278 PMID: 33401516. 21. Kayalar M, Bal E, Toros T, Ozaksar K, Gürbüz Y, Ademoğlu Y. Results of partial matrixectomy for chronic ingrown toe- nail.  Foot Ankle Int. 2011;32(9):888-895. DOI: 10.3113/ FAI.2011.0888 PMID: 22097165. 22. Rusmir A, Salerno A. Postoperative infection after excisional toenail matrixectomy: a retrospective clinical audit. J Am Podi- atr Med Assoc. 2011;101(4):316-322. DOI: 10.7547/1010316 PMID: 21817000. Surg Engl. 2011 Mar;93(2):99-102. DOI: 10.1308/003588411X 12851639107674. Epub 2010 Nov 12. PMID: 21073822. 13. Yang G, Yanchar NL, Lo AY, Jones SA. Treatment of ingrown toe- nails in the pediatric population. J Pediatr Surg. 2008;43(5):931- 935. DOI: 10.1016/j.jpedsurg.2007.12.042 PMID: 18485969. 14. Andreassi A, Grimaldi L, D'Aniello C, Pianigiani E, Bilenchi R. Segmental phenolization for the treatment of ingrowing toenails: a review of 6 years experience. J Dermatolog Treat. 2004;15(3):179- 181. DOI: 10.1080/09546630410026860 PMID: 15204151. 15. Romero-Pérez D, Betlloch-Mas I, Encabo-Durán B. Onychoc- ryptosis: a long-term retrospective and comparative follow-up study of surgical and phenol chemical matricectomy in 520 pro- cedures.  Int J Dermatol. 2017;56(2):221-224. DOI: 10.1111 /ijd.13406 PMID: 27734499. 16. Córdoba-Fernández A, Lobo-Martín A. Hemostatic Efficacy of Absorbable Gelatin Sponges for Surgical Nail Matrixectomy af- ter Phenolization-A Blinded Randomized Controlled Trial. J Clin Med. 2022;11(9):2420. Published 2022 Apr 26. DOI: 10.3390 /jcm11092420 PMID: 35566545. 17. Barreiros H, Matos D, Goulão J, Serrano P, João A, Brandão FM. Using 80% trichloroacetic acid in the treatment of ingrown toenails. An Bras Dermatol. 2013 Nov-Dec;88(6):889-93. DOI: 10.1590/abd1806-4841.20132296. PMID: 24474095.