Virtual Reality in Ingrown Toenail Surgery

July 13, 2026 updated by: ESRA KIRATLI NALBANT, Ankara City Hospital Bilkent

The Effect of Virtual Reality Headset Use on Pain and Anxiety in Patients Undergoing Ingrown Toenail Surgery

Ingrown toenail is a common condition that may cause significant pain, functional impairment, and recurrent disease. Although conservative management is appropriate for mild cases, moderate-to-severe or recurrent ingrown toenails are commonly treated surgically under local anesthesia. However, pain associated with the digital nerve block and procedure-related anxiety may negatively affect the patient experience. Virtual reality (VR) has emerged as a promising non-pharmacological intervention for reducing pain and anxiety during a variety of medical procedures by providing an immersive distraction. Nevertheless, evidence regarding its use during ingrown toenail surgery remains limited. The primary objective of this study is to evaluate the effect of VR on procedure-related pain intensity and anxiety in adults undergoing outpatient ingrown toenail surgery under local anesthesia compared with standard care. Secondary objectives include assessing the effects of VR on physiological arousal parameters, patient satisfaction, and safety.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Esra Kiratli Nalbant, Assistant Professor
  • Phone Number: +905069173233
  • Email: eekiratli@gmail.com

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18-65 years.
  • Patients presenting to the Dermatology Outpatient Clinic of Ankara Bilkent City Hospital with ingrown toenails who are scheduled for surgical treatment based on the severity and recurrence of the condition.
  • Ability to provide written informed consent.

Exclusion Criteria:

  • Inability to read, understand, or sign the informed consent form.
  • Active infection, including infection at the surgical site.
  • History of epilepsy or seizures of any etiology
  • Hearing impairment or requirement for a hearing aid that would interfere with the VR intervention or study instructions. 6. Presence of a cardiac pacemaker or any implanted medical device.
  • History of neurological disorders (e.g., migraine).
  • Inability to understand or speak Turkish.
  • Active psychiatric disorder, use of anxiolytic or antidepressant medication that may influence anxiety assessment, panic disorder, or claustrophobia.
  • Visual impairment preventing the use of the VR device.
  • Cardiac or metabolic disorders that may affect heart rate.
  • History of vertigo.
  • Cervical spine disorders involving the head or neck region.
  • Known anemia, history of methemoglobinemia, or glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Known allergy to local anesthetics.
  • Previous ingrown toenail surgery.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: VR group
Participants will undergo standard outpatient ingrown toenail surgery under local anesthesia. During the procedure, they will wear a virtual reality headset with headphones and view an immersive nature-based video accompanied by relaxing environmental sounds. All surgical and postoperative care will be identical to the control group.
Other: Virtual Reality (VR)
Participants will wear a virtual reality headset with headphones during outpatient ingrown toenail surgery performed under local anesthesia. The VR intervention consists of immersive nature-based audiovisual content, including forest, ocean, and tropical beach environments accompanied by relaxing natural sounds, and is used as a non-pharmacological distraction technique throughout the procedure.
No Intervention: Standard Care Group
Participants will undergo standard outpatient ingrown toenail surgery under local anesthesia without the use of a virtual reality headset. All surgical procedures, perioperative management, and postoperative care will be identical to those in the VR group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
State anxiety score
Time Frame: Baseline (before the procedure) and 30 minutes after completion of the procedure.
State anxiety assessed using the State-Trait Anxiety Inventory-State (STAI-State) questionnaire. Scores range from 0 to 80, with higher scores indicating greater anxiety.
Baseline (before the procedure) and 30 minutes after completion of the procedure.
Pain intensity (Visual Analog Scale, VAS)
Time Frame: Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after completion of the procedure.
Pain intensity measured using a 10-cm Visual Analog Scale (VAS) ranging from 0 to 10. The effect of virtual reality on procedure-related pain will be evaluated by comparing VAS scores between the study groups.
Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after completion of the procedure.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Heart rate
Time Frame: Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after the procedure.
Heart rate (beats/min) measured to evaluate physiological arousal associated with the procedure.
Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after the procedure.
Blood pressure
Time Frame: Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after the procedure.
Systolic and diastolic blood pressure (mmHg) measured to assess physiological responses to the procedure.
Baseline (before the procedure), within 2 minutes after digital nerve block, and 30 minutes after the procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara City Hospital Bilkent

Investigators

  • Principal Investigator: Esra Kiratli Nalbant, Assistant Professor, Ankara City Hospital Bilkent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 20, 2026

Primary Completion (Estimated)

November 15, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

July 13, 2026

First Submitted That Met QC Criteria

July 13, 2026

First Posted (Actual)

July 16, 2026

Study Record Updates

Last Update Posted (Actual)

July 16, 2026

Last Update Submitted That Met QC Criteria

July 13, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2026-1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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