cqvip:Background. The treatment of choice for an ingrowing nail has been su rgical r ather than nonsurgical. Yet, surgical treatments are far from successful, cause pain and patient apprehension, and leave disfigurement. Further, there is misund erstanding about the disease pathophysiology. Objective. To demonstrate the bene fits of a noninvasive method of treatment for an ingrowing nail using gutter spl int and formable acrylics and to present a current understanding of the disease pathophysiology. Methods. From a total of 541 cases of ingrowing nails treated, full follow-up data were obtained between January 1979 and March 2002. Formable acrylic treatments were carried out in 106 cases treated with acryli c-affixed gutter splint, 17 cases with sculptured nails, and 28 cases in which the two treatments were combined. These were then compared with 233 cases treat ed with adhesive tape-attached gutter splint and the remainder with other cons ervativemodalities. Results. Acrylic treatment with gutter splint and sculptured nail was found to be vastly superior to the other methods described, especially in the ability to firmly affix the gutter splint and sculptured nail for the ex tended period required for treatment. The treatment leads to a complete remissio n with almost instant alleviation of pain, with no disfigurement, while allowing for the resumption of daily activities. Conclusion. Conservative methods utiliz ing formable acrylics are highly beneficial in the treatment of an ingrowing nai l and should be viewed as the first treatment option.
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