Ingrown Toenail Treatment & Nail Surgery

Nail surgery is a procedure carried out to remove part, or all of a nail. Problem nails that we commonly treat are infected ingrowing toenails and curved or distorted/thick nails that are causing pain. Phenol may be used to stop regrowth of the nail.

Permanent removal of part or all of the nail often cures the problem, although there is a small risk of regrowth. This procedure is known as ‘Phenol Matricectomy’ and has a success rate of 95% or higher, in preventing re-growth of the nail.

• You will be awake during the procedure, and it is recommended you do not watch, in case it makes you feel unwell.
• A local anaesthetic is injected in the toe to stop you feeling pain. A tourniquet is then put onto the toe to reduce any bleeding.
• The piece of nail causing the problem is then removed, and phenol applied to stop the nail from growing back.
• The tourniquet is taken off and a dressing is put on to cover the toe. If you have sickle cell anaemia, use of tourniquet is not recommended – please discuss with your podiatrist.
• You will be given advice about how to look after your toe and a follow-up appointment, will be booked before you leave.

0. Once the toe has been anaesthetised (numbed), you will be able to move the toe but will not feel any pain. There is some discomfort when injecting the anaesthetic but this only lasts a couple of minutes. The local anaesthetic usually wears off in 2-4 hours.

• If you have an active job, you may need to take a few days off work to rest the affected toes.
• We recommend that you wear open toe shoes until the first redressing appointment. Please beaware that these may not comply with work Health & Safety requirements.
• We would recommend that school children do not go back to school until after the firstappointment where the toe is dressed (3 to 5 days).
• Surgery can be arranged to avoid clashes with other commitments for example, exams,

holidays.

• In rare circumstances, if a local anaesthetic cannot be used, a referral can be written for the procedure to be carried out under a general anaesthetic.
• Careful nail cutting. We can give you nail care advice to help you maintain your nails.
• Avoid tight footwear. If foot health is too poor for the procedure to be carried out, packing thecorners of curved nails or cutting back by the podiatrist.

• If the nail is causing bacterial infection, then the infection is likely to reoccur even with repeated courses of antibiotics.
• If the nail is causing discomfort this may continue.
• Infection, if present, may spread to the foot and leg, or into the blood stream causing septicaemia and other life-threatening complications.
• Loss of nail plate from infection or inflammation of the nail bed. Chronic ingrowing nails can cause deformity of the nail plate and/or surrounding soft tissues.
• A small benign tumour called a granuloma can form along the nail margin.
• Diabetics and those with poor circulation to the feet must never attempt to treat an ingrown toenail at home, consult a Podiatrist or doctor immediately.

Nail surgery is carried out in one of our treatment rooms. Please ensure you arrive early for your appointment. If you are late for your appointment there will be insufficient time to carry out the assessment, consent and treatment, and so the appointment will have to be re-booked.

0. The podiatrist will:
   • Explain the procedure and answer any questions
   • Carry out foot and general health checks. If you are taking any medication, please inform thepodiatrist.
   • Obtain your consent. You will need to sign a consent form which, if you have been give this priorto your procedure, you need to bring it with you on the day of the procedure.

Patients with type 1 and type 2 diabetes and patients undergoing treatment for cancer should have nail surgery with the NHS. At The Barn Clinic, we do not offer such patients with the above conditions nail surgery.

You will be called into the clinic room and the podiatrist or assistant will introduce themselves. Your details will be confirmed and medical information checked. The procedure will be explained again and confirmation of consent sought. Any questions you have can be discussed and answered.