Mini‐Winograd Procedure and Preoperative Nail Groove Drainage for Pyogenic Paronychia With Granulation Tissue

Background Pyogenic paronychia with granulation tissue usually requires surgical intervention and preoperative inflammation control. We developed a modified surgical procedure (the mini‐Winograd procedure) and an innovative method for preoperative inflammation control for such cases. Methods and Materials Between June 2022 and June 2023, 100 consecutive patients who underwent the mini‐Winograd procedure were retrospectively analyzed, including 43 patients with preoperative nail groove drainage and 57 patients with traditional preoperative treatment. Perioperative conditions were compared. Results Preoperative inflammation (42.1% vs. 7.0%, p < 0.001), postoperative edema (36.8% vs. 14.0%, p = 0.020), and postoperative pain (VAS: 3.2 ± 1.6 vs. 2.3 ± 1.2, p = 0.001) were significantly less in patients with preoperative nail groove drainage. Patients with drainage gained earlier recovery in walking ability (3.1 ± 1.0 vs. 2.7 ± 1.1, p = 0.035). The logistic regression results indicated that the preoperative inflammation status was an independent risk factor for SSI (OR = 11.67; p < 0.001) and postoperative severe pain (OR = 22.73; p = 0.003). Conclusion The mini‐Winograd procedure with preoperative nail groove drainage is an effective treatment for pyogenic paronychia with granulation tissue, which improves preoperative inflammation management, reduces postoperative pain, and enhances recovery.