Influence of Smoking on Wound Healing in Patients Undergoing Nail Matrix Phenolization: A Prospective Randomized Clinical StudyA Prospective Randomized Clinical StudyAdvances in Skin & Wound Care: May 2014 - Volume 27 - Issue 5 - p 237–238 doi: 10.1097/01.ASW.0000446522.88948.fa Features: Clinical Management Extra Figure The clinician explains to Mrs A. that her wound healing time can be reduced by eliminating extrinsic factors, such as smoking and diabetes. infection. burn depth. nature of initial injury. When providing wound care, the clinician encourages smoking cessation because smoking increases tissue oxygenation. temporarily increases aerobe metabolism. elevates oxidative bactericidal mechanisms. reduces inflammatory cell chemotactic response. The patient who smokes is advised that postoperative complications experienced more often by smokers include hemorrhage. flap necrosis. bowel obstruction. nausea and vomiting. A meta-analysis report revealed fewer wound healing complications with smoking abstinence for at least 1 to 2 days. 4 to 6 days. 1 to 2 weeks. 3 to 4 weeks. When treatment options for onychocryptosis are discussed, a consideration for use of phenol ablation includes faster healing rates. less serous drainage. superior cosmetic results. decreased risk for infection. A disadvantage of chemical cauterization for treatment of onychocryptosis is delayed healing. higher recurrence rates. greater postoperative pain. inability to use if sepsis is present. Previous cases in the literature of full-thickness burns to the great toe after phenol ablation for onychocryptosis reported the need for amputation. multiple skin grafts. prolonged serous drainage. cosmetic treatments of the toenail. Patients were monitored during this study for spontaneous wound closure healing with use of digital photographs for a period of 48 hours. 4 days. 1 week. 1 month. One of the clinical criteria used to determine early healing time for this study was the presence of limited infection. absence of exudate drainage. presence of hypergranulation tissue. absence of a scab on granulation tissue. The sample within the phenolization group in this study had a greater number of female smokers than male smokers. men with nail folds than women. women older than 35 years than men. female nonsmokers than the curettage group. In the phenolization alone group, the mean healing time was longer in the smoking group than in the nonsmoking group by approximately 1 day. 2 days. 4 days. 6 days. In this study’s curettage group, the smokers had a mean healing time of approximately 5 days. 8 days. 10 days. 13 days. Past phenol use with cutaneous procedures on smokers revealed that after performing phenol peels, 3 long-term smokers developed sepsis. laryngeal edema. exudate drainage. severe constant pain. When determining treatment recommendations for smokers, review of a 2010 study demonstrated that smoking has a transient effect on reparative functions. the proliferative response. the tissue microenvironment. cellular inflammatory functions. Partial ablation from segmental phenolization of the affected nail folds performed in this study was dressed with a nonsterile compressive bandage. 1 gauze pad placed around the hallux. an adherent polypropylene dressing. a thin layer of sulfadiazine silver cream. Before the surgical procedure performed in this study, patients allergic to penicillin had received an antibiotic prophylaxis of a single dose of 500 mg of cephalexin. a single dose of 500 mg of levofloxacin. 2 doses of 1 g of levofloxacin. 2 doses of 2 g of cephalexin. Findings from Boberg et al showed complete destruction of the germinal nail matrix with a minimum of 2% phenol solution for 2 minutes. 26% phenol solution for 2 minutes. 89% phenol solution for 1 minute. 100% phenol solution for 1 minute. Mrs J. refuses to quit smoking before a surgical procedure. The clinician explains to her that a 2012 study found that perioperative smoking cessation reduces graft necrosis. serous drainage. wound dehiscence. surgical site infections. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. All world rights reserved.