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Risk factors for infection following ingrowing toenail surgery: a retrospective cohort study

Journal of foot and ankle research, 2020-07, Vol.13 (1), p.1-n/a [Peer Reviewed Journal]

2020 The Authors ;COPYRIGHT 2020 BioMed Central Ltd. ;COPYRIGHT 2020 BioMed Central Ltd. ;2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2020 ;ISSN: 1757-1146 ;EISSN: 1757-1146 ;DOI: 10.1186/s13047-020-00414-y ;PMID: 32727511

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  • Title:
    Risk factors for infection following ingrowing toenail surgery: a retrospective cohort study
  • Author: Terrill, Alexander J. ; Green, Katie J. ; Salerno, Angelo ; Butterworth, Paul A.
  • Subjects: Age ; Ankle ; Audits ; Data collection ; Demographics ; Fingers & toes ; Health aspects ; Infection ; Infections ; Ingrowing toenail ; Medical research ; Medical societies ; Medicine, Experimental ; Nail surgery ; Onychocryptosis ; Orthopedic surgery ; Physicians ; Podiatrists ; Podiatry ; Postoperative infection ; Risk factors ; Surgeons ; Surgery ; Systemic diseases ; Toenail
  • Is Part Of: Journal of foot and ankle research, 2020-07, Vol.13 (1), p.1-n/a
  • Description: Background Ingrowing toenails are a common and painful condition often requiring surgical management. Practitioners who perform surgery on ingrowing toenails include orthopaedic surgeons, general practitioners, podiatrists and podiatric surgeons. There has been limited investigation into the specific surgical approaches used by Australian podiatric surgeons for ingrowing toenails, or the associated infection rates for these procedures. The aim of this study was to assess the frequency and type of ingrowing toenail surgery performed by podiatric surgeons, and identify risk factors for post‐operative infection. Methods Data was entered into the Australian College Podiatric Surgeons (ACPS) National Audit Tool for all patients who underwent foot and ankle surgery performed by podiatric surgeons in Australia between January 2014 and December 2017. Infection within the first 30 days following surgery was recorded according to the ACPS national audit descriptors. Infection rates, risk ratios (RR) and 95% Confidence Intervals (CI) were calculated to determine postoperative infection risk. Results Of 7682 records, 1831 reported 2712 diagnoses of ingrowing nails. Patients with a diagnosis of ingrowing toenails were younger, less likely to have systemic disease, and a lower proportion were female compared to those without ingrowing toenails. Furthermore, they were more likely to be diagnosed with a post‐operative infection than those without ingrowing toenails (RR = 2.72; CI = 2.00–3.69; P < 0.01). Univariate risk factors for post‐operative infection following ingrowing toenail surgery include age greater than 60 years (RR = 3.16; CI = 1.53–6.51; P < 0.01), surgery performed in an office setting (RR = 1.77; CI = 1.05–2.98; P = 0.04), and radical excision of toenail bed procedure (RR = 2.35; CI = 1.08–5.01; P = 0.04). Patients that underwent radical excision or office based procedures were on average older, and more likely to have systemic disease. Further, radical excision procedures were more likely to be performed in office base settings. Conclusions Ingrowing toenail surgery carries a greater risk of postoperative infection than other procedures performed by podiatric surgeons. Radical excision of toenail bed was associated with higher postoperative infection rates compared to other ingrowing toenail procedures. Procedures performed in an office setting carry a higher risk of infection. Further research into these associations is recommended.
  • Publisher: London: BioMed Central
  • Language: English
  • Identifier: ISSN: 1757-1146
    EISSN: 1757-1146
    DOI: 10.1186/s13047-020-00414-y
    PMID: 32727511
  • Source: GFMER Free Medical Journals
    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
    ProQuest Central
    DOAJ Directory of Open Access Journals
    Springer Nature OA Free Journals
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