Nail Surgery Gallery
Sterilisation Procedures
We take sterilisation and cleanliness in our practice very seriously. All podiatry instruments are autoclave sterilised in accordance with HSE Standards and Recommended Practices for Local Decontamination Units in Primary Care Dental, Podiatry and GP Practice. https://www.hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/hcai/resources/dental/sop-10-decontamination-of-reusable-invasive-medical-devices-rimd-.pdf
NAIL SURGERY PROCEDURE
The partial (one side or two sides) or entire removal of nail plate is carried out in a sterile environment using sterile (autoclaved) instruments and dressings. Following local anesthesias, a digital block & pre-surgical scrub to the foot, a tourniquet is applied to stem blood flow and recorded in the patient's notes. We identify the portion of the nail plate to be removed and separate the eponychium (nail bed) from the nail plate and matrix. In partial removals only, we then split the nail vertically with a sharp chisel blade and gain a firm hold of the nail plate using forceps, gently rotating towards the centre of the toe and pulling forward. Petroleum jelly is applied to the surrounding skin at the base of the toe to protect against unnecessary burns. We then rub liquified phenol (acid) to the germinal matrix for a minimum of 3 minutes and flush/irrigate the acid with chlorohexidine 0.5% and saline solution to neutralise. The tourniquet is then removed restoring arterial blood flow and an alginate sterile dressing is applied.
INGROWN TOENAIL(S) & NAIL SURGERY
Treatment Options
Conservative Treatment for Ingrown Toenails (for mild cases)
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Soaking: The podiatrist may recommend soaking the foot in warm water several times a day to reduce swelling and soften the nail.
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Lifting the Nail: The podiatrist may lift the ingrown portion of the nail and place cotton, dental floss, or a splint underneath to help the nail grow above the skin edge.
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Antibiotic Cream: An over-the-counter or prescribed antibiotic ointment may be applied to prevent infection.
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Trimming the Nail: The podiatrist may gently trim the ingrown part of the nail and offer guidance on proper nail-cutting techniques to prevent future issues.
Partial Nail Removal of Ingrown Toenails (for moderate to severe cases)
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Partial Nail Avulsion: In this procedure, the podiatrist will numb the toe and then cut away the part of the nail that is ingrown. This allows the nail to regrow properly and relieves the pressure.
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Chemical Ablation: After removing part of the nail, the podiatrist may use a chemical (like phenol) to destroy the nail matrix and prevent the ingrown section from regrowing.
Full Nail Removal (for severe or recurrent cases)
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Total Nail Avulsion: In rare cases where the ingrown toenail is recurrent or severe, the entire nail may need to be removed. The podiatrist will numb the toe, remove the nail, and apply a chemical to prevent regrowth if needed.
Infection Management
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If an infection is present, the podiatrist may prescribe oral antibiotics to eliminate the infection before or after the procedure.
Follow-up Care
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After treatment, the podiatrist may recommend wearing open-toed shoes or loose-fitting shoes, keeping the toe clean, and monitoring for any signs of recurrence.
Podiatrists are experts in treating foot conditions, so they ensure the ingrown toenail is resolved safely and with minimal discomfort.
FAQ
How long does it take to recover from toenail removal?
Healing time varies, but on average it takes four to six weeks to heal one side or two sides of the nail that had been removed at the same time. However, due to a larger surface area of the wound, It takes on average 10 to 12 weeks if the whole nail is removed and phenolised. During this time you will be able to walk and carry on your life as normal although you should avoid sporting activities or dancing to limit the risk of unnecessary trauma. Following nail surgery, we will schedule all your post-operative wound management appointments.
How painful is toenail removal?
Does it hurt? Ingrown toenails are a common cause of pain, disability and absence of work and nail surgery is now the most common surgical procedure carried out in the clinic. Some people report that the injection of local anaesthetic prior to surgery mildly uncomfortable but this pain is short-lived. You may have pain after surgery once the anaesthetic wears off. The application of phenol has an analgesic effect and because of this, some people report no pain after surgery.
Can I drive after ingrown toenail surgery?
No, not until the anaesthetic has completely worn off and your sensation has returned to normal. It is also not recommended that you drive any significant distance for the first couple of days after surgery.
How much pain should I expect after surgery?
This depends on individual patients, but the surgical site may feel uncomfortable for a couple of days. The application of phenol has an analgesic effect and often people report little to no pain after surgery.
How long after toenail removal can I wear shoes?
You should wear loose-fitting shoes or trainers with a round, deep toe box for the first 2 weeks after the procedure. Please avoid wearing high-heeled or tight-fitting shoes in the future. You should avoid running, jumping, or strenuous activity for 2 weeks after the surgery.