Management of Ingrowing Nails by Bertrand Richert Nilton Di Chiacchio Marie Caucanas & Nilton Gioia Di Chiacchio

Author:Bertrand Richert, Nilton Di Chiacchio, Marie Caucanas & Nilton Gioia Di Chiacchio
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Radiocautery

Radiocautery is a term used to describe a high-frequency electrosurgery. It uses tissue resistance to the passage of high-frequency alternating current to convert electric energy to heat, resulting in thermal tissue damage. Heat generation occurs within the tissue, while the treatment electrode remains ‘cold’. This makes radiofrequency more selective and reduces heat generation thus producing only a very narrow margin of thermal tissue destruction, accelerating wound healing and improving scarring [22]. Radiosurgery should not be performed in patients with cardiac pacemakers.

The surgical procedure is identical to the one for electrocautery. The spade-like electrode is rubbed onto the lateral horn of the matrix after avulsion of a lateral strip of nail. Special insulated electrodes are designed for the treatment of ingrowing toenail with radiosurgery. The electrode is flexible and coated for protection of the upper tissue (ventral part of the proximal nail fold) while it destroys the underlying matrix layers (Fig. 4.5). This makes the radiofrequency machine virtually as versatile as the CO2 laser at a much lower cost [23].

Fig. 4.5Spade-like coated and insulated bending electrode used in radiosurgery for the destruction of the lateral horn of the matrix

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