INFORMATION AND ADVICE FOR PATIENTS UNDERGOING INGROWING TOENAIL SURGERY
When the edge of a toenail grows into the skin fold beside the nail, the skin becomes red, hot, swollen and tender. This is called an Ingrowing toenail. Sometimes bacteria from the skin get into the inflamed skin and an infection begins. This can result in more inflammation and can spread throughout the toe into the foot. Pus may discharge from the edge of the nail.
The nail can dig into the surrounding nail because it is excessively curved or has become ragged and sharp following an injury. Often they seem to occur for no particular reason.
Following assessment by your GP, you may be advised to have surgery to correct the problem. Dr Allen, Dr Turner or Dr Thompson will perform this at the surgery. If you have a preference for the doctor that you would like to perform the surgery please let our nursing administrator Sian, know as soon as possible. If you do have a preference this may result in you waiting longer to have your procedure performed.
Please let us know if you cannot make your appointment. We can always fit another patient in, provided that we are given prior notice within a reasonable amount of time. Some patients simply don't bother to turn up, despite being contacted by us beforehand with their appointment date & time. This is a terrible waste of our time and leads to longer waiting times for all.
Please do not bring children with you when you have surgery.
What to expect when you arrive for your minor surgery
You should go to the Reception desk and book in. The doctor performing your surgery will then collect you from the waiting room. Please do not be late for your appointment – If you are more than 5 minutes late then your procedure may have to be cancelled and rebooked.
Before your surgery, the Doctor will explain exactly what procedure is being done and why. You will have the opportunity to ask any questions about the procedure being performed and/or any alternative treatments - including the medical consequences of "doing nothing" and not having surgery.
You need to take the rest of the day off work following the procedure, and depending on your type of work and how quickly you recover, you may need 2 days (in a job at a desk where you can raise your leg) to a couple of weeks out of work (e.g. in a job requiring steel-toe capped boots that may be very uncomfortable to wear for a week or two). In exceptional cases a few weeks off may be required.
It is important when coming for the surgery that someone comes with you to assist you in getting home. You should not drive after the procedure.
TYPES OF SURGERY
The doctor performing the surgery will explain the procedure, how to look after the toe following the procedure and potential complications, before the surgery. He will then ask you to sign a consent form.
There are two main procedures conducted here at Elbury Moor.
In both cases the toe is fully anaesthetised by injecting it with local anaesthetic on either side of its base. The doctor will check that the toe is fully anaesthetised before operating. You will be aware of pressure sensations but should not be aware of any pain. If you are, please inform the doctor immediately.
The toe then has a tourniquet (usually an elastic band) tightened around its base to minimise bleeding. It then has iodine painted on it to clean and sterilise it.
The toenail is either removed completely or a ‘wedge resection’ is performed.
If the nail is removed completely the idea is to allow the nail bed time to heal and for a new nail to grow – this can take 6 months.
In a wedge resection the section of nail that is ingrown is removed and the nail bed underneath is destroyed by applying a chemical (phenol) to prevent any nail regrowth. Consequently your toenail will look narrower than it did before.
LOOKING AFTER YOUR TOE AFTER SURGERY
In all instances the toe will have a large bandage on it, which will prevent you from wearing any close fitting shoes – open-toed sandals are best worn on the day of surgery and for a few days afterwards.
The anaesthetic wears off a few hours after surgery – as it starts to wear off it is advisable to take some painkillers (paracetamol) so as to minimise the discomfort.
The dressing should be left on for 24 hours. It can then be removed; the last layers may be best soaked off in a saline bath. In any case once the dressing is removed please bath the toe for 10-15 minutes in a bowl with saline water in it (one teaspoon of salt for every pint of water). The toe is then best dried using a hairdryer on the cool setting. It is then best to dress the toe using a non-adherent dressing such as ‘release’ (available from the chemist). Repeat this procedure daily until the toe is healed. On average nail surgery takes 6 –12 weeks to heal.
COMPLICATIONS
The surgery is intended to be curative, in a small percentage of cases the ingrowing toenail can recur.
Wound infection can occur – with increased swelling, redness and sometimes pus seen around the surgery site. If this occurs see your GP.
Minor chemical burns to the surrounding skin can occur if phenol has been used.
Slower healing can occur than describe above.
When the nail is completely removed, the new nail may have a different appearance to the previous nail.
Please note this information is intended as guidance only. If you have any particular queries please discuss with the doctor performing the procedure
NBIf you intend to go on holiday within a month of your minor operation date, please can you let us know as this will mean another patient on the waiting list can be seen sooner