Nailbed Repair for Patients With Nailbed Injuries

Stanford University

Status: Begins enrollment in 2 months

Conditions: Nail Place Disruption; Nail Laceration; Nail Bed Injury

Treatments: Other: Nail Bed Repair; Other: Nail bed dressing

Study type: Interventional

Funder types: Other

Identifiers

NCT07388823

82680

Details and patient eligibility

About

This study compares the outcomes of fixing nail bed injuries with nail bed repair versus irrigation and dressing alone. The main question this study aims to answer is "Does nail bed repair after nail bed injury lead to better outcomes?"

Full description

This study compares two treatment methods for patients with nail bed injuries. The first method is irrigation and dressing. The second method is nail bed repair. Patients will be randomized into one of the two groups and outcomes will be documented in both groups.

Enrollment: 100 estimated patients

Sex: All

Ages: 2+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients 2+ years of age
• presenting with disruption of nail plate or laceration adjacent to nail which appears that it may extend into the nail matrix OR subungual hematoma >50% of nail
• presenting within 3 days of acute injury

Exclusion criteria

• missing (e.g. avulsed) nail bed or segment of nail bed,
• prior injury to affected nail
• need for surgical treatment of injury (e.g. underlying operative fracture)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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100 participants in 2 patient groups

Irrigation and Dressing

Active Comparator group

Description:

Patients in this arm will receive the following treatment protocol: 1. If there is a subungual hematoma \>50% of the nail, trephinate the nail plate using an 18G needle 2. Irrigate wound with at least 500cc normal saline 3. Dress finger with bacitracin, xeroform, and 2" kling wrap 4. Splint finger as needed with alumifoam splint (apply splint to volar side of finger so as to avoid pressure to nail bed) 5. Repair any other lacerations as needed

Treatment:

Other: Nail bed dressing

Nail bed repair

Experimental group

Description:

Patients in this arm will receive the following treatment protocol: 1. Block involved digit with 3cc 1% lidocaine injected subcutaneously over volar and dorsal metacarpophalangeal joint 2. Apply tourniquet to base of finger if desired 3. Remove nail using freer/hemostats 4. Irrigate wound with at least 500cc normal saline 5. Repair nail bed laceration with 5-0 chromic or monocryl suture 6. Stent eponychium with native nail or fashion substitute from foil suture packet and secure with 2 sutures 7. Dress finger with bacitracin, xeroform, and 2" kling wrap 8. Splint finger as needed with alumifoam splint (apply splint to volar side of finger so as to avoid pressure to nail bed) 9. Repair any other lacerations as needed

Treatment:

Other: Nail Bed Repair