Comparison of Winograd VS Sleeve Technique in The Treatment of Ingrown Toenail - A Randomized Clinical Trial in Tertiary Care Setting, Islamabad

Abstract

Objective: To compare the recurrence rate following Sleeve and Winograd surgery for ingrown toenails.
Study Design: Randomized clinical trial.
Place and Duration of Study: This study was conducted at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, from June 2024 to September 2025.
Methods: Patients between 12 and 75 years old and with clinically diagnosed IGTN were enrolled. The included patients exhibited at least two clinical signs such as discomfort, swelling, redness, or tissue overgrowth. Patients with diabetes, vascular disease, cancer, or low immunity were excluded. The patients were randomly divided into two groups: Group A (Winograd) and Group B (Sleeve). The study involved 312 nails (156 nails per group). Surgeries were performed according to standardized protocols, and recurrence was assessed within 30 days using predefined criteria. Data were collected on a prescribed proforma and analyzed using SPSS v25.
Stratification was done among various confounding variables for the recurrence and compared for both groups, and a P-value ≤0.05 was considered statistically significant.
Results: The mean age of patients was 43.33±19.48 years, with male predominance. The mean duration of symptoms was 46.71±24.32 days. Recurrence was significantly higher in the Sleeve group (23.1%) than the Winograd group (14.1%) (P=0.042). Subgroup analysis showed significantly greater recurrence with Sleeve among males (P=0.009), obese individuals (P=0.007), and those without hyperhidrosis (P=0.023). Other demographic and clinical variables showed no significant effect.
Conclusion: The Winograd technique showed a much lower recurrence rate than the Sleeve method, especially in males and obese patients, thereby justifying its use as a more definitive surgical procedure in IGTN.

How to cite this: Hussain A, Waqar SH, Karim F, Irfan MA, Ali MF. Comparison of Winograd VS Sleeve Technique in The Treatment of
Ingrown Toenail - A Randomized Clinical Trial in Tertiary Care Setting, Islamabad. Life and Science. 2026; 7(3): 359-365. doi:
http://doi.org/10.37185/LnS.1.1.1196