WOFAPS 2025 8th World Congress of Pediatric Surgery

Marta Januszaniec Włodarska, Roksana Barglik, Aleksandra Jasińska

Uniwerysteckie Centrum Kliniczne WUM, Warsaw, Poland

Ingrown toenails are a common condition among teenagers. The nail plate grows into the surrounding tissue, causing swelling, redness, and pain in the lateral nail folds. This usually affects the toenails, especially the big toe. The commonly chosen method of treating ingrown toenails is a wedge resection. This surgical procedure is performed under local anesthetic which removes the lateral aspect of the nail down to the matrix. A normal healing process is 6-8 weeks with an earlier return to daily activities. We would like to present differentiated, innovative methods of treatment of complicated wounds, which can occur even after simple surgical procedures. A 12-year-old boy was admitted to the Department of Pediatric Surgery through the emergency department, due to a necrotic phlegmon of his bilateral great toes. He underwent a bilateral wedge resection 1 week prior at a private clinic. Purulent discharge with separation of bilateral nail folds penetrating to the distal phalangeal bones was observed. During hospitalization, the wounds were repeatedly surgically debrided. Hyperbaric chamber therapy, specialized dressings and negative pressure therapy was applied. The wounds were treated with PRP, IPRF, and filled with APRF autologous dressings. Additionally, Cold Plasma Aerosol was used, and early rehabilitation was implemented. After several weeks of hospitalization, proper wound healing was achieved. The use of various treatment methods, selected for the appropriate wound healing phase, increases chances of a full and quick recovery.