Objective:To investigate the effect of traditional Chinese medicine (TCM) lotion on incidence of postoperative infection and recurrence of refractory paronychia.Methods:Seventy-eight patients with intractable paronychia who received treatment at Hangzhou Third People's Hospital from January 2019 to November 2022 were included in this study. The patients were randomly divided into the povidone-iodine group ( n = 39) and the TCM lotion group ( n = 39) using the random number table method. Both groups underwent matrixectomy via a lateral incision and rhomboid flap excision surgery. Prior to the procedure, the povidone-iodine group received treatment with a 5% povidone-iodine solution, whereas the TCM lotion group was administered a TCM lotion containing Scutellaria barbata, Verbena, Lonicera japonica, Viola, Rheum palmatum, Atractylodes, Glauber's salt, Phellodendron, red peony root, Glycyrrhiza uralensis, and Magnolia officinalis. Both groups underwent treatment until the patients fulfilled the surgical indications and were subsequently observed for a period of 6 months post-surgery. The clinical efficacy was evaluated 1 month after the surgical intervention. A comparative analysis was conducted to assess the postoperative duration of redness and swelling, pus discharge, granulation, and pain resolution between the two groups. Additionally, the postoperative occurrence of wound-dressing adhesion, the status of wound healing, pain intensity at 1 and 3 days post-surgery, the incidence of infection at 1 week post-surgery, and the recurrence rates at 1 and 6 months post-surgery, were compared between the two groups. Results:At 1 month post-surgery, the total effective rate in the TCM lotion group was 92.31% (36/39), which was significantly higher than that in the povidone-iodine group [71.79% (28/39), χ2 = 4.26, P < 0.05]. The postoperative durations of redness and swelling, pus discharge, granulation, and pain resolution in the TCM lotion group were (5.66 ± 0.58) days, (3.64 ± 0.55) days, (8.42 ± 1.58) days, and (3.36 ± 0.32) days, respectively, which were significantly shorter than those in the povidone-iodine group [(6.73 ± 0.65) days, (4.56 ± 0.48) days, (9.77 ± 2.56) days, (3.89 ± 0.48) days, t = 7.67, 7.87, 2.80, 5.73, all P < 0.05]. The proportion of mild adhesion between the wound and dressing was significantly higher, while the proportion of severe adhesion was significantly lower, compared with the povidone-iodine group ( Z = 4.64, both P < 0.05). The durations of postoperative pain, the time to redness resolution, and wound healing time in the TCM lotion group were (4.22 ± 1.73) days, (3.02 ± 1.16) days, and (11.84 ± 2.50) days, which were significantly shorter than those in the povidone-iodine group [(8.53 ± 2.48) days, (5.20 ± 2.31) days, (13.32 ± 2.86) days, t = 8.90, 5.26, 2.43, all P < 0.001]. At 3 days post-surgery, pain scores in each group were significantly lower than the respective scores at 1 day post-surgery. At 1 and 3 days post-surgery, pain scores in the TCM lotion group were (3.30 ± 0.18) points and (2.28 ± 0.23) points, respectively, which were significantly lower than the respective scores in the povidone-iodine group [(3.61 ± 0.29) points, (2.52 ± 0.33) points, t = 5.67, 3.72, both P < 0.05]. There were no significant differences in the incidence of infection at 1 week post-surgery and the recurrence of refractory paronychia at 1 and 6 months post-surgery between the two groups (all P > 0.05). Conclusion:The combination of TCM lotion and matrixectomy through a lateral incision and rhomboid flap excision surgery for the treatment of refractory paronychia can help shorten pre-operative treatment time, minimizes postoperative wound-dressing adhesion, promote wound healing, alleviate postoperative pain, and decrease the incidence of infection and recurrence of refractory paronychia, demonstrating superior efficacy compared with treatment with a 5% povidone-iodine solution.