BACKGROUND: Phenol cauterization is a chemical equivalent often chosen for treatment of ingrown toenails. Many reports describe intraoperative irrigation, or lavage, of the wound with various types of alcohol to neutralize any remaining phenol. There are conflicting reports in the literature as to whether true neutralization or merely effective removal of excess phenol is needed. OBJECTIVE: The aim of our study was to analyze the suitability and effectiveness of ethyl alcohol versus sterile saline when used in a lavage step after phenol application in the treatment of ingrown toenails. METHODS: We performed an in vitro study using human skin and a diffusion cell apparatus to measure the amount of phenol recovered after lavage with ethyl alcohol or sterile saline. RESULTS: When the wound was irrigated with ethyl alcohol, the total phenol recovered after two irrigation washes was 55.7% of the original amount initially used in treatment, compared with 80.4% when sterile saline solution was used for irrigation. CONCLUSION: Alcohol and sterile saline solution do not neutralize phenol but dilute it and aid in its removal. We found that saline solution recovered more phenol than when washing with alcohol and recommend its use instead of alcohol for irrigation purposes after chemical matrixectomy.
BACKGROUND:Phenol cauterization is a chemical equivalent often chosen for treatment of ingrown toenails. Many reports describe intraoperative irrigation, or lavage, of the wound with various types of alcohol to neutralize any remaining phenol. There are conflicting reports in the literature as to whether true neutralization or merely effective removal of excess phenol is needed. OBJECTIVE: The aim of our study was to analyze the suitability and effectiveness of ethyl alcohol versus sterile saline when used in a lavage step after phenol application in the treatment of ingrown toenails. METHODS: We performed an in vitro study using human skin and a diffusion cell apparatus to measure the amount of phenol recovered after lavage with ethyl alcohol or sterile saline. RESULTS: When the wound was irrigated with ethyl alcohol, the total phenol recovered after two irrigation washes was 55.7% of the original amount initially used in treatment, compared with 80.4% when sterile saline solution was used for irrigation. CONCLUSION:Alcohol and sterile saline solution do not neutralize phenol but dilute it and aid in its removal. We found that saline solution recovered more phenol than when washing with alcohol and recommend its use instead of alcohol for irrigation purposes after chemical matrixectomy.