NAIL SURGERY

Nail surgery is a minor surgical procedure performed under local anaesthetic to remove all or part of your toenail. It is usually required when an ingrowing toenail is frequently recurring causing pain and discomfort or infection. The procedure can also be performed for cosmetic reasons where the nail has become damaged and unsightly but causes no pain. Minor surgery is a simple procedure and is permanent solution to the problem.

IN GROWING TOENAIL

An ingrown toenail is a common condition which can be very painful often leading to repeated infection and prolonged discomfort. The condition needs to be accurately diagnosed as poor self-treatment often leads to misdiagnosis. A true ingrowing toe nail is where the nail plate has excessive curvature. This will predispose the nail to grow into the skin at the side of the nail, or for the skin to swell and press into the nail causing pain, and commonly leads to infection. Nail surgery is easily and effectively performed using local anaesthetic to treat and prevent regrowth of the affected nail. The procedure takes up to an hour and the patient can return to work and their normal routine the following day.

WILL IT GET WORSE?

The infection and swelling generally gets worse if untreated.

WHAT ARE THE COMMON SYMPTOMS?

 

• Pain

• Swelling

• Bleeding / weeping

• Foul odour

• Difficulty in shoes

• Difficulty walking

 

HOW IS IT RECOGNISED?

This is easily diagnosed on clinical examination.

WHAT CAN I DO TO REDUCE THE PAIN?

There are several things that you can do to try and relieve your symptoms:

• Wear broad good fitting shoes with adequate depth

• Bathe the foot in warm, salt water daily

• Keep the toe covered with a clean / sterile dressing (this will reduce the risk of infection)

• Consult your GP/podiatrist

 

WHAT WILL HAPPEN IF I LEAVE THIS ALONE?

It is likely to get worse.

TOENAIL SURGERY FREQUENTLY ASKED QUESTIONS:

WILL I HAVE TO BE PUT BE ASLEEP?

No, the procedure is performed perfectly safely under local anaesthetic (you are awake). There is no need to worry, you will feel no pain during the operation as the toe will be totally numb.

I HAVE HEARD THE OPERATION IS VERY PAINFUL

No, this is not the case. The procedure is carried out using local anaesthetic which is injected using a very fine gauged needle into both sides of the base of the toe. Relief is immediate and generally only low grade pain will be experienced once the anaesthetic has worn off. As long as you keep pressure off the toe immediately following the surgery you should experience little or no further discomfort.

WILL IT BE PAINFUL AFTERWARDS?

The anaesthetic will last for approximately three hours. Some patients may experience slight discomfort after the anaesthetic has worn off. If this occurs, routine doses of paracetamol are normally sufficient to reduce this discomfort.

WHAT WILL HAPPEN DURING THE OPERATION?

The operation will be performed under local anaesthetic, so you are awake and can eat normally up until the time of your operation. The injection is given at the base of the affected toes and is very similar to a dental injection. The actual procedure will last only 10-15 minutes, but the whole appointment usually lasts around an hour, to allow for sufficient preparation and postoperative monitoring.. Dressings will be applied to the toe. A dressing pack will be given to you following the procedure and advice leaflet. You will be given a follow up appointment around 3-4 days after. Once you have been discharged from the clinic it is your personal responsibility to look after the surgical wound and manage the dressings accordingly as advised by your podiatrist. It is advisable to wear a sandal after the operation, and we strongly advise that someone else drives you home, as your insurance may be invalidated should you be involved in an accident.

WHAT ARE THE ADVANTAGES OF THIS OPERATION?

 

• Less discomfort.

• No or reduced episodes of infection.

• Easier mobility.

• More choice of footwear.

• Generally happier foot health.

Whilst it cannot be 100% guaranteed that you will never have another problem with the toe or be completely pain free, it is highly likely that your you will have any further problems

 

HOW LONG WILL IT TAKE FOR ME TO RECOVER?

On the first night, you should not drive following the operation. We advise you to arrange a lift or get a taxi from the clinic after the procedure. After most minor surgical procedures it is generally advised to rest on the first night and take painkillers if necessary.

During the first week a strict regimen of dressing the wound (toe) is required. This is because the application of phenol to destroy the nail bed causes a chemical burn, which takes time to heal and you have an "open wound" It is strongly advised to keep the toe covered at all times with a sterile dressing to keep it clean and minimise the risk of infection. You will be able to walk/work but sensible footwear is advised and sport or strenuous exercise is not recommended. If problems present you will be seen again at the clinic.

DRESSINGS AND FOLLOW-UP.

You will normally return within a 2-3 days to have the toe checked and re- dressed. The dressing will require to be changed on a regular basis and your podiatrist will discuss with you the most suitable arrangements to ensure that your wound receives appropriate care until it is healed.

BETWEEN 2-6 WEEKS FOLLOWING THE PROCEDURE.

You need to keep dressing the toe until it stops weeping, usually when it becomes a bit dry and crusty and a healthy looking pinkish colour. This usually takes on average 3-4 weeks. Please note that once the operation has taken place it is the patient's responsibility to look after and maintain good dressing technique, if complications arise due to poor dressings, recovery will ultimately be delayed, for example not wearing a sterile dressing at all times.