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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ingrown toenail is a very common disease that causes pain and disability&#46; There are many different surgical strategies to address this condition&#44; which rely on two main approaches&#58; narrowing the nail plate or debulking soft tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This study presents an improvement in the surgical technique&#44; by combining the two approaches&#44; and performing the standardized six steps to ensure a higher cure rate and appropriate aesthetic effect&#46; This research was approved by the Ethics Committee of the Fifth Affiliated Hospital&#44; Sun Yat-sen University&#44; under protocol number K148-1&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">The study enrolled 67 patients with ingrown toenail in varying degrees of severity between January 2018 and September 2019&#46; The procedure was performed through the following standardized six steps &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#8211;G&#41;&#58; &#40;A&#41; A longitudinal resection line was identified according to the part of ingrown nail that needed to be removed&#59; &#40;B&#41; from the junction point between the margin of eponychium and the longitudinal resection line&#44; a 45-degree angle excision was performed&#59; &#40;C&#41; an arc incision was made along the lateral nail fold&#44; assuring that the range included the hypertrophic granulation tissue&#59; &#40;D&#41; the ingrown nail plate was cut along the longitudinal line and the hypertrophic tissue and corresponding part of nail matrix were completely removed&#59; &#40;E&#41; the proximal lateral nail fold was sutured&#44; using two or more Nylon 4&#47;0 sutures&#59; &#40;F&#41; in order to fixate the nail margin on the toe&#47;finger&#44; one or more Nylon 2&#47;0 sutures were performed as needed&#59; &#40;G&#41; the immediate appearance of the toe&#47;fingernail after the operation&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">The healing process lasted from three to four weeks&#44; approximately&#44; and sutures were removed on the 14<span class="elsevierStyleSup">th</span> postoperative day &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Fifteen of 67 patients received the treatment for the bilateral toenails&#46; Almost all the patients experienced postsurgical pain&#44; but only five required non-steroid anti-inflammatory drugs &#40;NSAIDs&#41;&#46; All the cases received the management with water-filtered infrared-A &#40;wIRA&#41; and only three severe cases presented local infection&#44; requiring antibiotics&#46; The appearance of the nail was nearly unchanged&#44; and no patients complained about the cosmetic results &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Ingrown nails seriously impact the daily life of patients&#44; most of whom underwent a long and repeated course of the condition before being referred to a dermatologist&#46; In fact&#44; a large number of dermatologists are unfamiliar with the surgical technique and there is no consensus on which is the best operation to treat ingrown toenails&#46; The recurrence rate for surgical approaches is between 1&#46;7&#37; and 27&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In contrast&#44; the present technique was used to treat 67 patients&#44; and had no recurrence observed after six months to one year of follow-up&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Subsequently&#44; the key points about the procedure are listed&#46; &#40;1&#41; Step 4 is the most important procedure to avoid the recurrence&#46; The author&#8217;s experience is that it is enough to cut off the nail root tissues and see the white phalanx&#46; In order to minimize the risk of recurrence&#44; a small wedge-shaped resection inward is usually performed at the end point of the nail plate&#44; which does not affect the nail appearance&#46; &#40;2&#41; Sometimes the disease course was too long and a large mass can be observed in the triangular region&#44; so it might be difficult to suture the nail plate and surrounding tissues in step 6&#44; if the resection was too wide and left an ample space beside the nail&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>A&#46; It is better to keep 0&#46;5&#8239;cm width&#59; even if a small amount of necrotic tissue is left behind&#44; it would be absorbed gradually&#46; &#40;3&#41; If the nail plate is too thick &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>B&#41; to cross-section easily&#44; the entire plate should be removed before the procedure &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>C&#41;&#46; &#40;4&#41; In order to better protect the nail bed and decrease the risk of postsurgical infection&#44; a &#8220;Y&#8221; dressing and water-filtered infrared-A &#40;wIRA&#41; were used after the operation &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>D&#41;&#46; They were effective techniques&#44; as suggested by the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusion</span><p id="par0030" class="elsevierStylePara elsevierViewall">The author introduces an effective and simple surgical method to treat ingrown toenails&#46; The recurrence rate is lower than the other methods&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Author contribution</span><p id="par0040" class="elsevierStylePara elsevierViewall">Han MA&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Dermatologists don&#8217;t have a good knowledge of the surgical treatment for ingrown toenails and there is no consensus on which is the best approach&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To develop an easy and effective surgical approach to solve the problem of ingrown toenails&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We identified 67 patients with ingrown toenails in varying degrees of severity which were treated with the standardized approach&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">All the patients had a completely recovery from the disease and none complained about the cosmetic result&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The number of cases is limited&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The standardized surgical approach is easily learned and very effective&#46; The recurrence rate is lower than with other treatments&#46;</p></span>"
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