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Table 1 Therapeutic options according to classification of toe ingrowth [7]

From: Surgical site infection leading to gangrene and amputation after ambulatory surgical care of an ingrown toenail: a case report

Onychrocryptosis (toe ingrowth)
Stage IStage IIStage IIIStage IVStage V
Local irritation
No infection, pus or granulation tissue.
Infection without a history of onychocryptosis.
Pus and/or Granulation tissue
Infection with history of more than one episode of onychocryptosis.
Infective onychocryptosis with partial onycholysis of a single nail border.Infective onychocryptosis with partial onycholysis of both nail borders.
May Perform CauterizationDo Not Perform Cauterization
Treatment (Stage 1)Treatment (Stage 2)Treatment (Stage 3)Treatment (Stages 4,5)
1.Self Treatment
2. Slant Back
3. Suppan
4. Chemical
5. Laser
6. Cold steel
7. Daily soaking
1. Slant Back
2. Suppan
3. Chemical
4. Laser
5. Cold steel
6. Daily soaking
1. Winograd
2. Chemical
3. Laser
4. Cold steel
5. Daily Soaking
1. Remove offending nailborder or nail plate.
2. Resection of hypertrophic ungualabia.
3. Radiographs or magnetic resonance imaging is indicated in Chronic cases to rule out osteomyelitis.
4. Address osteomyelitis or periostitis.
4. Return for secondary stage
procedure to include matrixectomy.
5. Resolve infection to return to Stage
1,2 or 3 for appropriate procedure.