Pulpar-Far Resection: A Novel Surgical Technique Compared to the Winograd Method in the Treatment of Ingrown Toenails

Authors : Ekrem Özdemir, Nasuhi Altay, Fatih Emre Topsakal, Mehmet Koçaslan, Erdem Yunus Uymur, Esra Demirel

Pages : 327-333

View : 21 | Download : 64

Publication Date : 2026-01-05

Article Type : Research Paper

Abstract :Aim: To compare the clinical and cosmetic outcomes of the novel Pulpar-Far resection with the conventional Winograd technique in the surgical treatment of stage 2 and 3 onychocryptosis. Materials and Methods: This retrospective cohort study included 108 patients (mean age, 27.57 years) who underwent surgical treatment for stage 2 or 3 onychocryptosis between November 2021 and November 2023. Patients were treated with either the Pulpar- Far resection (n=54) or the Winograd procedure (n=54). Clinical outcomes included postoperative pain assessed using the Visual Analog Scale (VAS), recovery time, and time to return to daily activities. Recurrence rates and patient-reported cosmetic satisfaction were also evaluated. All patients had a minimum follow-up of 12 months, with a mean follow-up duration of 20.17±7.88 months. Results: Patients who underwent the Pulpar-Far resection showed significantly quicker recovery (12.72±1.47 vs. 17.61±2.39 days; p <0.001) and an earlier return to activities (3.80±1.23 vs. 7.46±2.27 days; p <0.001) compared to those who had the Winograd procedure. One-week postoperative VAS pain scores were notably lower in the Pulpar-Far group (3.20±0.96 vs. 5.35±1.23; p <0.001). Cosmetic satisfaction was also higher in the Pulpar-Far group (98.1% vs. 81.48%; p <0.001). Although recurrence rates were lower with Pulpar-Far resection (1.85% vs. 9.26%), this difference was not statistically significant (p=0.204). Conclusion: Pulpar-Far resection provides superior postoperative recovery, reduced pain, and improved cosmetic satisfaction compared with the Winograd technique in the treatment of advanced onychocryptosis. As a novel surgical approach, it represents a promising alternative, particularly for patients in whom aesthetic outcomes are a priority.
Keywords : cosmetic satisfaction, ingrown toenail, minimally invasive procedure, pulpar-far resection, recurrence, Winograd technique

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