Comparative Analysis of Rate of Recurrence Using Sodium Hydroxide versus Phenol for Chemical Matrixectomies of Toenails.

Background: Chemical matrixectomy using acidic phenol or alkaline sodium hydroxide (NaOH) is indicated when prevention of toenail growth is preferred. The literature reports outcomes for phenol and NaOH independently; however, no studies are found to compare recurrence rates. This study evaluates the efficacy of these chemicals in preventing nail growth recurrence while analyzing whether age, sex, and body mass index contribute to regrowth after chemical matrixectomy.

Methods: From July 1, 2019, to July 1, 2021, data were obtained for toenail removal procedures that include Current Procedural Terminology codes 11730, 11750, and 11732 and corresponding International Classification of Diseases, Tenth Revision code S61.309A.

Results: Descriptive statistical analyses were conducted on 138 patients who underwent partial or total chemical matrixectomy. A χ2 test, a Fisher exact test, and an independent two-sample test were used to compare health and demographic characteristics on only patients who underwent a chemical matrixectomy (n = 58), evaluating differences between NaOH and phenol. The mean patient age was 43.2 years. Most patients (72%) did not have a previous revision. Approximately 54% of patients underwent partial nail avulsions without chemical matrixectomies versus 44% who had chemical matrixectomies. No statistically significant differences were found between groups. Comparison of recurrence rates did not demonstrate a statistically significant difference between NaOH and phenol. No association was found between nail growth recurrence and age.

Conclusion: Further investigation into application times, technique, and severity of deformity may provide further insight into factors leading to recurrence.