Topical Collagen-Silver Versus Standard Care Following Removal of Ingrown Nails

• time to return to regular shoe gear [ Time Frame: weekly ] [ Designated as safety issue: No ]
• days unable to work [ Time Frame: weekly ] [ Designated as safety issue: No ]

This study's purpose is to prospectively determine whether topical therapy with an oxidized regenerated cellulose collagen-silver compound is more effective than the current standard of topical antibiotic therapy for care following the removal of an ingrown toenail. Eighty adult patients with ingrown toenails will be recruited. Each patient will randomly be assigned to apply either topical silver sulfadiazine cream (standard antibiotic) or the novel collagen-silver compound to their nail bed daily, following removal of the ingrown portion of nail. Patients will return for follow up visits weekly, until healing has occurred or twelve weeks have passed. Healing will be defined as resolution of drainage and inflammatory changes surrounding the nail border.

• Device: oxidized regenerated cellulose collagen-silver
  Wound dressed daily with oxidized regenerated cellulose collagen-silver matrix.
  Other Name: Prisma
• Drug: topical silver sulfadiazine cream
  Cream will be applied to nailbed daily and dressed with a bandage until healing occurs.
  Other Name: Silvadene, Thermazene

• Experimental: experimental
  Subjects will daily dress their nail bed with oxidized regenerated cellulose collagen-silver, until healing occurs.
  Intervention: Device: oxidized regenerated cellulose collagen-silver
• Active Comparator: Control
  Topical silver sulfadiazine cream will be applied daily to the wound bed until healing has occured.
  Intervention: Drug: topical silver sulfadiazine cream

Inclusion Criteria:

• Ingrown toenails will be defined as any incurvated nail border that digs into the skin of the nail fold and causes pain and discomfort

Exclusion Criteria:

• Patients with immunocompromised states

  • chronic steroid use
  • diabetes mellitus
  • collagen vascular disease
  • HIV infection
• Cellulitis proximal to the hallux interphalangeal joint or peripheral vascular disease will be excluded
• We will define peripheral vascular disease as the absence of one or more pedal pulses or the presence of dystrophic changes to the integument