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Research ArticleResearch Briefs

Patient-Controlled Taping for the Treatment of Ingrown Toenails

Meiko Tsunoda and Koichi Tsunoda
The Annals of Family Medicine November 2014, 12 (6) 553-555; DOI: https://doi.org/10.1370/afm.1712
Meiko Tsunoda
1Department of Dermatology, Tsunoda Clinic, Tokyo, Japan
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Koichi Tsunoda
2Department of Artificial Organs and Medical Device Creation, National Institute of Sensory Organs, National Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
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  • For correspondence: tsunodakoichi@kankakuki.go.jp
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  • New taping method for ingrown toenail
    Hossein Alinia
    Published on: 29 January 2015
  • Author response: Possibilities regarding the usage of similar types of tapes.
    Meiko Tsunoda
    Published on: 05 January 2015
  • Significance of self-controlled care
    Kazutoshi Shibuya
    Published on: 19 December 2014
  • Author response: Patient-Controlled Taping for the Treatment of Ingrown Toenails
    Meiko Tsunoda
    Published on: 20 November 2014
  • Patient-controlled taping method for ingrown toenail
    Kiyoshi Nishioka
    Published on: 17 November 2014
  • Published on: (29 January 2015)
    Page navigation anchor for New taping method for ingrown toenail
    New taping method for ingrown toenail
    • Hossein Alinia, Dermatologist
    • Other Contributors:

    Ingrown toenails occurs when the nail fold is traumatized by the nail plate. Ingrown toenails occur in up to 20% of patients visiting family physicians with foot problems.[1] Different methods of treatment (taping, packing, gutter, brace, hygienic measures, and surgical procedures) have been described for treatment of an ingrown toenail.[2] Management options can be chosen based on the stage of the ingrown nail or structure of...

    Show More

    Ingrown toenails occurs when the nail fold is traumatized by the nail plate. Ingrown toenails occur in up to 20% of patients visiting family physicians with foot problems.[1] Different methods of treatment (taping, packing, gutter, brace, hygienic measures, and surgical procedures) have been described for treatment of an ingrown toenail.[2] Management options can be chosen based on the stage of the ingrown nail or structure of nail edge (normal nails vs. abnormally wide or curved).[3] Many patients prefer conservative methods over surgical treatments; conservative approaches are more cost effective, do not have the contraindications of surgical treatment, and are reasonable initial treatments for mild to moderate cases.[1]

    Taping has been described as one of the least invasive ingrown nail treatments. Taping is done to pull the traumatized lateral nail fold away from the nail plate edge in mild cases.[2] There is a paucity of literature about taping methods. Tsunoda et al published an interesting retrospective observational study on 750 ingrown nails. Of these, 88 had previous surgery. They used a mesh elastic adhesive tape of 25 mm in width and about 35 mm in length. With one end of the tape attached along the lateral nail fold, the first 1cm of the tape was stretched toward the plantar surface and the residual part of the tape was fixed in the plantar surface without any stretch. The stretch of webbed tape seems to provide a force toward the center of stretched part, pulling the nail fold and wound away from the nail plate promoting wound healing [4] (Figure 1). [annfammed.org/site/misc/TRACK/AliniaTableFigure.doc]

    After two month follow up of treatment, the response rate was higher among 662 patients who did not have previous surgery compared to those had surgery before (47.7% vs. 20.4%).[4] By not completely encircling the toe with tape, there was less skin irritation, joint movement restriction and circulation problem expected than conventional taping method. The study and treatment method did have some limitations (Table 1). [annfammed.org/site/misc/TRACK/AliniaTableFigure.doc]

    To better define how effective this approach is, it would help to have a randomized controlled study for mild to moderate cases compared with a "no treatment" or other conservative treatment as a control group, comparing the improvement rate, satisfaction and the quality of life with longer follow up period.

    References:
    1. Heidelbaugh JJ, Lee H. Management of the ingrown toenail. Am Fam Physician. 2009 Feb 15;79(4):303-8.
    2. Haneke E. Controversies in the treatment of ingrown nails. Dermatol Res Pract. 2012;2012:783924. doi: 10.1155/2012/783924. Epub 2012 May 20.
    3. Park DH, Singh D. The management of ingrowing toenails. BMJ. 2012 Apr 3;344:e2089. doi: 10.1136/bmj.e2089.
    4. Tsunoda M, Tsunoda K. Patient-controlled taping for the treatment of ingrown toenails. Ann Fam Med. 2014 Nov-Dec;12(6):553-5. doi: 10.1370/afm.1712.
    5. Taheri A, Mansoori P, Alinia H, Lewallen R, Feldman SR. A Conservative Method to Gutter Splint Ingrown Toenails. JAMA Dermatol. 2014 Dec 1;150(12):1359-1360. doi: 10.1001/jamadermatol.2014.1757.

    Hossein Alinia MD [1], Arash Taheri MD [1,2] and Steven R. Feldman MD, PhD [1,3,4]
    Wake Forest University School of Medicine
    1. Center for Dermatology Research, Department of Dermatology
    2. Department of Internal Medicine
    3. Department of Pathology
    4. Department of Public Health Sciences

    Competing interests: Hossein Alinia and Arash Taheri have no conflict of interest to disclose. Dr. Feldman is a speaker for Janssen and Taro. He is a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, Leo Pharma Inc. Dr. Feldman has received grants from Galderma, Janssen, Abbott Labs, Amgen, Stiefel/GlaxoSmithKline, Celgene and Anacor. He is a consultant for Amgen, Baxter, Caremark, Gerson Lehrman Group, Guidepoint Global, Hanall Pharmaceutical Co Ltd, Kikaku, Lilly, Merck & Co Inc, Merz Pharmaceuticals, Mylan, Novartis Pharmaceuticals, Pfizer Inc, Qurient, Suncare Research and Xenoport. He is on an advisory board for Pfizer Inc. Dr. Feldman is the founder and holds stock in Causa Research and holds stock and is majority owner in Medical Quality Enhancement Corporation. He receives Royalties from UpToDate and Xlibris.

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    Competing Interests: None declared.
  • Published on: (5 January 2015)
    Page navigation anchor for Author response: Possibilities regarding the usage of similar types of tapes.
    Author response: Possibilities regarding the usage of similar types of tapes.
    • Meiko Tsunoda, Director
    • Other Contributors:

    Dear Dr. Kazutoshi Shibuya,

    I was delighted to receive your letter, and was especially pleased to read you kind words regarding our procedure. I whole heartedly agree with your statement that, "it should be understood as an essentially important procedure for physicians involved by primary case." This is absolutely on point. Primary physicians as well as their patients will most definitely benefit from this proced...

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    Dear Dr. Kazutoshi Shibuya,

    I was delighted to receive your letter, and was especially pleased to read you kind words regarding our procedure. I whole heartedly agree with your statement that, "it should be understood as an essentially important procedure for physicians involved by primary case." This is absolutely on point. Primary physicians as well as their patients will most definitely benefit from this procedure. Since NICHIBAN tape is unavailable in some countries, we are trying to find a tape that is effective and widely available around the world. We want to receive reports about the usage of our technique employing similar types of tapes. Thank you again. Sincerely

    Meiko Tsunoda

    Competing interests: None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (19 December 2014)
    Page navigation anchor for Significance of self-controlled care
    Significance of self-controlled care
    • Kazutoshi Shibuya, Professor

    I have read Meiko's paper with great interest. Whereas the instruction for self-controlled care requires integrity and patience for physician, it should be understood as an essentially important procedure for physicians involved by primary case. In addition, Meiko's report confirmed safety and convenience of her recommendation. I wish to express my sincere congratulation for her successful publication of her work.

    ...
    Show More

    I have read Meiko's paper with great interest. Whereas the instruction for self-controlled care requires integrity and patience for physician, it should be understood as an essentially important procedure for physicians involved by primary case. In addition, Meiko's report confirmed safety and convenience of her recommendation. I wish to express my sincere congratulation for her successful publication of her work.

    Competing interests: Dr Shibuya reports receiving research funding from Pfizer, Dainippon Sumitomo Pharma, Astellas Pharma Inc. Dr Shibuya reports receiving personal speaker's fees from Pfizer, Dainippon Sumitomo Pharma, MSD KK, Astellas Pharma Inc., and Chugai Pharmaceutical Co. Ltd.

    Show Less
    Competing Interests: None declared.
  • Published on: (20 November 2014)
    Page navigation anchor for Author response: Patient-Controlled Taping for the Treatment of Ingrown Toenails
    Author response: Patient-Controlled Taping for the Treatment of Ingrown Toenails
    • Meiko Tsunoda, Director

    We are honored to hear from the pioneer of the taping method (for ingrown nail). Our research and challenge [1] was based on a report by Dr. Nishioka.[2] After 10 years, we upgraded the taping method with modern day elastic adhesive tape, which has drastically improved in quality since our last trial. Our attempt was to discover a more efficient procedure by studying our past report. We hope that our new taping method sp...

    Show More

    We are honored to hear from the pioneer of the taping method (for ingrown nail). Our research and challenge [1] was based on a report by Dr. Nishioka.[2] After 10 years, we upgraded the taping method with modern day elastic adhesive tape, which has drastically improved in quality since our last trial. Our attempt was to discover a more efficient procedure by studying our past report. We hope that our new taping method spreads across the world as the first line treatment of choice for ingrown nails.

    References
    1. Tsunoda M, Tsunoda K. Patient-controlled taping for the treatment of ingrown toenails. Ann Fam Med. 2014 Nov;12(6):553-5.
    2.Nishioka K, Katayama I, Kobayashi Y, Takijiri C, Nishioka K. Taping for embedded toenails. Br J Dermatol. 1985 Aug;113(2):246-7.

    Competing interests: None declared

    Show Less
    Competing Interests: None declared.
  • Published on: (17 November 2014)
    Page navigation anchor for Patient-controlled taping method for ingrown toenail
    Patient-controlled taping method for ingrown toenail
    • Kiyoshi Nishioka, Professor emeritus

    I read Tsunoda's paper with much interest. The taping technique is originated from our paper published in Brit J Dermatol 1985, in which we have tried to keep the original width of nail plate and to keep open the nail groove of affected toes. Now new materials of elastic adhesive tape are availabel for public use. Thunoda's modified technique is an easy, safe and cheap one to encourage patients to treat their nail at ho...

    Show More

    I read Tsunoda's paper with much interest. The taping technique is originated from our paper published in Brit J Dermatol 1985, in which we have tried to keep the original width of nail plate and to keep open the nail groove of affected toes. Now new materials of elastic adhesive tape are availabel for public use. Thunoda's modified technique is an easy, safe and cheap one to encourage patients to treat their nail at home. This technique will be widely applicable in the field of family medicine.

    Competing interests: None declared

    Show Less
    Competing Interests: None declared.
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The Annals of Family Medicine: 12 (6)
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November/December 2014
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Patient-Controlled Taping for the Treatment of Ingrown Toenails
Meiko Tsunoda, Koichi Tsunoda
The Annals of Family Medicine Nov 2014, 12 (6) 553-555; DOI: 10.1370/afm.1712

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Patient-Controlled Taping for the Treatment of Ingrown Toenails
Meiko Tsunoda, Koichi Tsunoda
The Annals of Family Medicine Nov 2014, 12 (6) 553-555; DOI: 10.1370/afm.1712
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