Wednesday, July 6, 2011

Performing a Nail Surgery

The spring and summer months bring flowers blooming, family picnics and a flare up of those pesky ingrown toenails.  With the renewed commitment to exercise after taking the winter season off, you can plan on the incidence of complications and infections related to ingrown toenails increasing.   The question is how to appropriately and effectively manage this very painful problem.

For a quick primer on Onychocryptosis click HERE!

One of the first questions is whether it is best to perform a simple slant back procedure, partial nail avulsion without chemical matrixectomy, partial nail matrixectomy or a total nail matrixectomy.

For a simple, first time ingrown toenail with paronychia you might consider doing a simple slant back procedure with a topical anesthetic spray and a small nail cutter.  Necessary instruments are listed below.



For nails that are chronically ingrown or damaged I would recommend considering a more permanent procedure. 

For diabetics that are poorly controlled or any patient with vascular compromise, I would caution the use of a chemical matrixectomy.  

As to the question of Sodium Hydroxide verses Phenol for chemical of choice, I choose Sodium Hydroxide.   I have used both chemicals in the past but have found that the tissue damage and irritation with Sodium Hydroxide is less then with Phenol.  This study published by the NIH comparing the Sodium Hydroxide and Phenol Matrixectomy showed significantly reduced healing times with Sodium Hydroxide use with comparable long term success rates.

Click HERE for Video of Partial Sodium Hydroxide Matrixectomy




Click HERE for Video of Post Op Nail Surgery Day 14




 Click Here for a Printable Post Op Nail Surgery Patient Instruction Sheet

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