Double versus single suture closure after the Winograd procedure for ingrown toenails: Functional outcomes and recurrence in a retrospective comparative cohort study.

Abstract

Ingrown toenails are frequently encountered in clinical practice and may result in pain, infection, and impaired daily function. The purpose of this study was to compare the clinical outcomes of double-suture closure with 0 polypropylene following the Winograd procedure with those of traditional single-suture closure using 3/0 polypropylene. Retrospective comparative cohort study. A total of 140 patients who underwent surgery using the Winograd technique were retrospectively analyzed. Patients were divided into two groups based on the closure technique: single-suture closure with 3/0 polypropylene or double-suture closure with 0 polypropylene. Clinical outcomes such as recurrence rate, time to return to work or school, time to resume wearing normal shoes, and operative time were evaluated. Intergroup statistical comparisons were performed using appropriate statistical tests. Among the 140 patients included in the study, 71 underwent single-suture closure and 69 underwent double-suture closure. The overall recurrence rate was 7.1%, with no statistically significant difference between the groups. However, the double-suture closure group had a shorter time to return to work or school (10.5 vs 12.1 days, P = 0.020) and earlier resumption of normal footwear (10.5 vs 13.1 days, P = 0.012), while operative time was slightly longer (P = 0.026). The double-suture closure using size 0 polypropylene technique provides faster functional recovery without increasing the recurrence rate. The double-suture closure technique may therefore represent a practical alternative for patients requiring an early return to daily activities.