Chronic paronychia treatment: Square flap technique.

BACKGROUND

Chronic paronychia is an inflammatory process of the periungual folds that lasts longer than 6 weeks. It manifests as hypertrophy of the proximal and lateral nailfolds, absence of cuticle, progressive retraction of the proximal nailfold, and onychodystrophy. Surgical treatment is recommended if there has been insufficient response to 6 months of appropriate medical therapies.

OBJECTIVE

We describe a new surgical technique that removes the fibrotic tissue without complete excision of the proximal and lateral nailfold, minimizing nailfold retraction and recovery time.

METHODS

We present a case series of 34 fingers (9 patients) treated with this new technique.

RESULTS

All nailfolds healed well without complications. At the end of the follow-up, all fingers, apart from 2, were relieved of the preoperative symptoms. The length of the ungual plate was maintained in all patients, with no retraction of the nailfolds.

LIMITATIONS: Follow-up period of 6 months and small sample size are limitations of this study.

CONCLUSION

This surgical technique can provide an alternative treatment for chronic paronychia, with good prognosis during follow up-period and optimal cosmetic results.