Novel Taping Method Reduced Surgery for Ingrown Toenails

Diedtra Henderson

November 14, 2014

Some 276 of 541 patients or guardians successfully treated ingrown or curved toenails with a simple, novel taping technique they could do themselves and then required no additional therapy for abnormal nail growth, according to an observational study.

Meiko Tsunoda, MD, from the Department of Dermatology, Tsunoda Clinic, Tokyo, Japan, and Koichi Tsunoda, MD, from the Department of Artificial Organs and Medical Device Creation, National Institute of Sensory Organs, National Tokyo Medical Center, National Hospital Organization, Tokyo, Japan, report the findings of their retrospective study in an article published in the November/December issue of the Annals of Family Medicine.

The authors note that a number of techniques are used to contend with ingrown or pincer-like toenails, including a standard taping technique that requires multiple visits to the clinic for retaping, packing with cotton wool, surgery, and "gutter" treatment. Such remedies, however, did not resolve the problem for the long term, and some patients suffered discomfort or dermatologic problems from taping.

The researchers relied on mesh elastic adhesive tape that is 25 mm wide and 3 to 4 cm long, which is wider and shorter than tape previously used. In addition, they stretched the tape less than 1 cm and did not completely encircle the toe.

Between December 1996 and July 2011, the clinicians taught 541 patients how to properly use their index fingers and thumbs to properly stretch, place, and hold the tape. They were instructed to change the tape at least daily and for up to 8 weeks, until the lateral nail edge was exposed. The researchers report that pain usually subsided for patients within a week of initiating the taping procedure.

The patients ranged in age from 1 to 93 years. As a group, there were 750 affected big toenails, and 66 patients had ingrown toenails that had worsened after surgery performed elsewhere. Almost half (44.5%) of the patients' ingrown toenails had the problem resolve without needing additional treatment; 265 patients needed nail bracing or surgery, but most reported pain relief. The authors note that patients who tried the taping before surgery were less likely to require additional surgery.

"The results of our retrospective observational study suggest that the novel taping method should be attempted before surgical treatment. Patients who had undergone surgery before using our taping method were more likely to require additional surgery, which may be attributed to the occurrence of postoperative side effects such as nail division, deformity, and/or spicule formation," the authors write.

Because patients themselves can remove and replace the tape, the researchers found it was easier for them to keep their toenails clean.

"An important element of our taping treatment is patient education," the authors conclude. "The taping technique and principle, as well as walking correctly, cutting the toenails square, and wearing appropriate footwear, may prevent the recurrence of ingrown nails."

Financial support for the study was provided by the National Hospital Organization, Japan. The authors have disclosed no relevant financial relationships.

Ann Fam Med. 2014;12:553-555. Full text

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