GreatSkin Medispas

Surgical procedure to remove a toenail that has curled and grown into the skin, causing pain.

 

Ingrown Nail

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Parts of the Body Involved

Toe and toenail, usually the big toe.

Reasons for Procedure

With this procedure, the entire nail or only the portion of the nail growing into the skin may be removed. It is most often performed for the following reasons:

• To relieve pain
• To relieve swelling (inflammation or infection)
• To remove a deformed nail
• To correct abnormal nail growth

Risk Factors for Complications During the Procedure

• Diabetes
• Problems with blood circulation

What to Expect

 

Prior to Procedure

Your doctor will likely do the following:

• Exam of the area
• Conservative care before surgery

The day of your procedure:

• Wear comfortable clothing and loose-fitting shoes.
• Arrange for a ride to and from the procedure.

 

Anesthesia

Local

 

Description of the Procedure

Local anesthetic is used to numb the area, usually the whole toe. The doctor will pull the nail up and cut along the edge that is growing into the skin. A chemical may be used to prevent the nail from growing back in the same area.

A total nail removal is a more extensive procedure. For a total nail removal, the doctor eliminates the nail, the nail bed, and any adjacent tissue. The tissue may be cut away and stitches used to close the area. Alternatively, a laser will be used to destroy the tissue, or an acidic chemical will be applied to kill the nail’s growth cells.

 

How Long Will It Take?

Less than 1 hour

 

Will It Hurt?

Most patients report no pain during the procedure once the anesthetic has been given. But injection of the local anesthetic can be painful; this discomfort can be reduced by careful administration by your doctor. Anesthetic injection into toes or fingers is usually quite painful due to tight skin and many nerve endings. Spraying with a topical anesthetic spray first before the injection may help. Some anesthetic preparations may be less irritating than others, so the doctor can reduce the discomfort somewhat.

 

Possible Complications

• Infection
• Excessive swelling or bleeding

 

Average Hospital Stay

None

 

Postoperative Care

• Do not put weight on the affected toe.
• If needed, take the pain medication ordered or over-the-counter pain remedy recommended by your doctor.
• Keep your foot elevated for the first day after the procedure.
• Soak your toe in warm, salt, or plain water for 10 to 20 minutes, two or three times each day for one week; soaking decreases pain and swelling.
• Keep a clean, dry dressing over the toe.
• Wash your hands before caring for the nail area or changing the dressing.
• Wear white, cotton socks and loose fitting shoes for about two weeks.
• Do not run or engage in strenuous activities until your doctor says you can, usually after about two weeks.

If your toe is infected:

• You’ll be given an antibiotic cream or ointment to treat the infection; do not touch the antibiotic with your finger, instead put a small dab of the cream on a clean dressing or sterile applicator and use that to touch your toe.
• For severe infections, you may need to take an antibiotic by mouth. If one is ordered, take all of the pills. Do not stop the medication, even if the toe looks better, unless told otherwise by your doctor.

To avoid future ingrown nails:

• Do not wear high heels or shoes that fit poorly.
• Trim your toenails straight across and do not pick or tear at them.
• Foot care is extremely important if you have diabetes, consider letting a podiatrist or other health professional trim your nails and examine your feet routinely.

Outcome

If needed, stitches are usually removed in about 10 days. Complete healing takes about two to three weeks but does not interfere with most daily activities. (Strenuous activities are limited for about two weeks as stated above.)

If the entire nail was removed, your body will generate a hard skin in its place. After the skin has covered the sensitive area, you can resume normal activities.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
• Chalky white, bluish, or blackish appearance to skin of toes or foot (Call immediately.)

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org

American College of Foot and Ankle Surgeons
http://www.footphysicians.com

CANADIAN RESOURCES:

Calgary Foot Clinic
http://www.foottalk.com

Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca/default.asp

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