Nail Surgery
Nail Surgery
Podiatrists are specialists and have developed highly successful techniques to treat all types of painful nail conditions — from nails which have become infected and septic to nails which are painful or troublesome due to their abnormal shape.
In certain circumstances, despite conservative treatment, some toenails may require removal.
Nail Surgery Explained
Risks and Benefits: Nail surgery is a low risk procedure, performed under local anaesthetic (LA). It involves removing all or part of a toe-nail then stopping the removed bit of nail from regrowing by applying phenol to the nail bed.
It is only performed after a thorough review of your medical history. Certain medical conditions or medications can affect the action of anaesthetics and also your ability to heal. Therefore, you must inform the podiatrist if you have experienced reactions to vaccinations or insect bites, such as fainting or breathlessness.
What does it involve?
Two injections of LA, one each side of the toe, are used to make the toe feel numb. This may be uncomfortable but once working, although you may feel a slight sense of pressure, you will not feel pain. There may be mild swelling or bruising in the area, which will soon disappear. Part or all of the toe-nail is carefully lifted from the nail bed, requiring no cutting (and so no stitches) of the skin. Liquid phenol is used to destroy the nail bed to prevent regrowth of the portion of nail that was removed. This can, in rare cases, cause slight burning or blistering which will be very limited. Finally, a sterile dressing is applied to prevent dirt getting into the wound. The procedure takes approximately 60 minutes. As the local anaesthetic takes 2-3 hours to wear off, you are advised not to drive yourself home, but to make alternative arrangements. Any discomfort or pain can be relieved by simple pain killers such as Paracetamol (not Aspirin). You will be given an information sheet on post-operative care before you leave the surgery, plus a date within 7 days for your re-dressing appointment, which must be kept.
How long does it take to heal?
Usually between 4 to 12 weeks, depending on the type of procedure performed. You can return to work the day after the procedure, providing you wear footwear which will accommodate the dressing that does not squeeze the toes. You will be expected to redress the area yourself in-between clinic appointments. There may be some discharge from the wound, but this is quite normal and should be expected. Post-operative infection is rare, and can easily be treated with a course of antibiotics. The wound will be monitored by us until healing is satisfactory.
Will the nail grow back?
Our research suggests up to 95% success with this particular form of treatment.
Will it be painful afterwards?
Some patients may experience discomfort after the anaesthetic has worn off. If this occurs, routine doses of your usual painkiller are normally sufficient to reduce the discomfort. It is advisable to bring loose fitting or open-toed footwear with you on the day of the procedure.
What are the risks?
The operation for removing an ingrown toenail is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
WHAT ARE THE POSSIBLE COMPLICATIONS/RISKS IN HAVING SURGERY?
Like all medical procedures there are risks in undergoing nail surgery. These are rare, but can include:
Infection
Bruising from the injection or tourniquet
An allergic reaction to the local anaesthetic
Pain (this will often subside within a few days)
Periostitis – inflammation/infection of the outer covering of the bone
Nail re-growth – it may also grow back deformed
Persistent wound drainage
Persistent numbness
Long healing time of between 6-12 weeks
Cosmetic changes – skin will eventually cover the removed nail.
On the day of your surgery you can eat and drink normally as the local anaesthetic has no effect on your digestive system. Please ensure your feet are clean and remove all traces of nail varnish from your toes. You will be asked to sign a consent form, if you are under 16 your parent will need to sign for you. Bring with you open toed shoes or sandals to allow room for the dressing which can be quite bulky. It will be necessary to arrange a lift home following your surgery and it is not advisable to drive for the rest of the day as the pressure may cause bleeding. Driving after a local anaesthetic in the toe may invalidate your insurance, if you do wish to drive please first check with your insurance company that you will be covered.