Tirnak Batmasinda Tirnak Teli Tedavisinin Etkinligi/Efficacy of Nail Brace Treatment For Ingrown Nails

Özet. Amaç: Tirnak batmasi; sik karsilasilan, agrili bir saglik problemidir. Tirnak batmasinin tedavisinde çok farkli konservatif ve cerrahi yöntemler tanimlanmistir. Bu çalismada; tirnak batmasi tedavisinde kolay ve ucuz bir konservatif tedavi olan tirnak telinin tedavi etkinligini, tirnak teli ile tedavi sonrasi nüks yüzdelerini ve nüks için risk faktörlerini saptamayi amaçlamaktayiz. Gereç ve Yöntem: Tirnak batmasi yakinmasi olan 14-73 yas araliginda bulunan 32'si kadin, 19'u erkek olmak üzere 51 hasta ve toplam 73 tirnak çalismamiza alinmistir. Granulasyon dokusu olan hastalara 3-7 gün araliklarla gümüs nitrat uygulanmi stir. Granulasyon dokusu olanlarda granulasyon dokusunun tamamen düzelmesi ve tirnak batmasi sikayetinin kalmadigi noktada, granulasyon dokusu olmayan hastalarda ise ilk ay haftada bir, sonrasinda ayda bir kontrol muayenelerinde batma sikayetinin kalmadigi noktada tirnak teli uygulamasi sonlandirilmistir. Bulgular: Tirnak batmasi mevcut olan hastalarin %98.6'i (72/73) tirnak teli ile tedaviden fayda görmüstür. Yetmis bir tirna- gin 12'sinde nüks tespit edilmis olup (%16.,9), 59 tirnagin nükssüz takibine devam edilmektedir. ki tirnagin 3 aylik tedavi sonrasi iyilik halinden sonra takibine ulasilamamistir. Tirnak teli ile tedavi edilen hastalar nüks açisindan degerlendirildiginde nüks eden tirnaklar ile nüks olmayan tirnaklar arasinda tirnak batmasinin evresi, granulasyon dokusu varligi, tirnagin kali nligi, tirnak körvünün açisi, yas,cinsiyet, hiperhidrozis varligi, sikayet süresi, tedavi süresi ve uygulanan toplam kuvvet baki mindan anlamli fark bulunmamistir. Sonuç: Tirnak teli uygulamasi tirnak batmasi olan hastalarin agri sikayetinin giderilmesinde ve tedavisinde etkili bulunmus ve tedavi sonrasi nüks açisindan istatistiksel olarak anlamli bir prediktif faktöre rastlanmamistir. (Türkderm 2010; 44: 88-91). Anahtar Kelimeler: Tirnak batmasi, tedavi, tirnak teli. Summary. Background and Design: Ingrown nail is a common, painful health problem. Various conservative and surgical methods have been defined for treatment of ingrown nails. In this study we aimed to evaluate the efficacy of nail brace treatment which is a cheap conservative treatment, recurrence percentages after nail brace treatment and risk factors for recurrence. Material and Method: Thirty-two female and 19 male patients with the complaint of ingrown nail aged 14-73 with a total of 73 nails are included to the study. Silver nitrate has been applied every 3-7 days to patients with granulation tissue. Nail brace application has been stopped in patients with granulation tissue once the granulation tissue has subsided and complaints have subsided, in patients without granulation tissue as their complaint was over during weekly controls in first month and monthly controls thereafter. Results: Ninety-eight point six percent of patients having ingrown nail (72/73) benefited from brace treatment. In 12 nails out of 71, recurrence has been established, in 59 nails follow-up without recurrence continues. Two nails have not been reached for followup after the first 3 month relief. Assessing patients treated with nail brace for recurrence, no significant difference was detected between recurrent and non-recurrent groups according to stage of ingrown nail, presence of granulation tissue, nail thickness, angle of nail curve, age, gender, presence of hyperhydrosis, duration of treatment and total force applied. Conclusion: Nail brace application has been found effective for pain relief and as treatment in patients with ingrown nails and no statistically significant predictive factor has been found in terms of recurrence after treatment. (Turkderm 2010; 44: 88-91). Key Words: Ingrown nail, treatment, nail brace.

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