Sodium Hydroxide versus Phenol Chemical Matrixectomy

Chemical matrixectomy (CM) is a common procedure to correct painful and ingrown toenails. At our institution, CMs are often performed with either sodium hydroxide (NaOH) or phenol as the chemical agent for germinal nail matrix destruction. The primary aim of this study was to evaluate the recurrence and reoperation rates for this procedure using different chemical agents. The medical records of 192 patients during a 2-year period were reviewed. All of the CMs were performed in a standard fashion by three podiatric physicians. Among phenol partial nail avulsions, 46 nail border removals were performed. Among NaOH partial nail avulsions, 258 nail borders were treated. Mean follow-up was 93 days (median, 17 days). Among partial nail avulsions, the mean reoperation rate per border for CM with phenol was 6.5%. In comparison, the reoperation rate for CM with NaOH was 7.8% (P = .89), indicating that there is no statistically significant difference in reoperation rates between these two chemicals. The mean recurrence of painful nail edge rate per border for CM with phenol was 10.9%. In contrast, with NaOH this rate was 8.1% (P = .58), indicating that there was no statistically significant difference in the rate of development of recurrent painful nail borders between the two procedures. This retrospective medical record review demonstrated little difference between these chemicals in their reoperation and recurrence rates.