Nail Surgery


 Angela Cottingham Lead Podiatrist, Achilles Centre Ltd.What is Nail Surgery?

Nail Surgery is the removal of either part or all of a nail under local anaesthetic.  It is a quick and effective long-term solution to many painful nail conditions.  Here at the Achilles Centre this is nearly always carried out in conjunction with chemical removal of the nail bed to prevent re-growth and possible recurrence of the original condition.

Why is Nail Surgery necessary?

Nail Surgery is indicated for several painful nail conditions, commonly in-growing and/or involuted nails.  

An in-growing toe-nail is one where the nail has either  broken away or been cut incorrectly leaving a rough shoulder or nail spike.  This may then penetrate the soft tissue of the toe, in the nail groove, as it grows.  Thus leading to an acutely painful, and often infected, toe.  

Involuted toe-nails are excessively curly from side to side leading to an excessive amount of pressure building-up in the nail groove along the nail edges.  This can cause hard skin or corns to develop resulting in chronic discomfort.

Most nail conditions can be dealt with conservatively, i.e. without surgery, and, where appropriate, this would always be the first choice of treatment.  However, in situations where the problem persists or fails to respond, nail surgery surgery might be indicated.  

What is involved

Nail Surgery is carried out here at the Achilles Centre at any time convenient to both the practitioner and patient, usually within a few days.  The patient will already have been assessed to ensure that surgery is appropriate, and a pre-operative assessment of general health will have been carried out.  Approximately one hour is required, with a follow-up appointment usually the following week.

A local anaesthetic is used, tourniquet applied, and the required amount of nail gently lifted off (no stitching is required and there is generally no bleeding).  A chemical is used to remove the nail bed and a large dressing then applied.   Patients are taken home by a friend or relative.  Analgesics are sometimes required within the first few hours post-operatively.

Are there any risk involved?nail surgery ingrowing

Yes.  These include a possibly post-operative infection, 'phenol flare' (localised swelling) where an individual reacts to the chemical used, and on rare occasions there may be small areas of re-growth.

Will the nail grow again?

In nearly every nail surgery procedure carried out at the Achilles Centre, the toe-nail and toe-nail bed will be removed in order to prevent the original problem recurring.  In a small percentage of cases there may be small areas of re-growth where a few nail producing cells remain.  Where this occurs it rarely causes problems.

 



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