This randomized clinical trial aims to compare the recurrence rates of two surgical techniques-Winograd procedure and sleeve (gutter) method-in the treatment of ingrown toenails (onychocryptosis). A total of 312 nails will be randomized into two groups, with patients receiving either the Winograd procedure or sleeve method. Participants will be followed for 30 days post-intervention to assess recurrence and other clinical outcomes. The study seeks to determine the more effective treatment modality for reducing recurrence in a tertiary care setting.
Patients presenting with ingrown toenail (onychocryptosis)
Patients for whom surgical intervention is indicated
Age between 12 and 75 years
Both male and female participants
Patients with diabetes mellitus
Patients with peripheral vascular disease
Immunocompromised patients
Patients with coagulopathy
Parallel
Winograd Technique
Procedure/SurgerySurgical partial nail avulsion with excision of the lateral nail matrix and nail fold. A longitudinal incision is made along the ingrown nail edge, followed by wedge resection of the nail matrix and surrounding soft tissue. The wound is closed with sutures.
Sleeve (Gutter) Method
Procedure/SurgeryPartial removal of the ingrown nail edge followed by insertion of a flexible tube beneath the nail margin to separate it from the surrounding soft tissue and guide proper nail growth. Granulation tissue, if present, is removed.
Recurrence of Ingrown Toenail
Recurrence is defined as the presence of pain, erythema, edema, discharge, or need for medical or surgical re-intervention at the same nail site.
Postoperative Infection
Presence of purulent discharge, redness, or need for antibiotics.
Wound healing
Assessment of healing progression at the surgical site.
Work loss days
Number of days patient is unable to resume normal activities/work.
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