Nail Surgery

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 Cheryl Scott Podiatry Clinic 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.

When is Nail Surgery Necessary

Nail Surgery is indicated for several painful nail conditions, commonly ingrowing and/or involuted nails. An ingrowing toenail is one where the nail has either broken away or been cut incorrectly leaving nail spike, which then penetrates the soft tissue of the toe as it grows. Thus leading to an acutely painful, and often infected, toe. Involuted toenails curbe at the edges leading to an excessive amount of pressure 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, ie. 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 to conservative treatment, nail surgery may be indicated. In all cases, your available options and their likely outcomes will be discussed with you, enabling you to make an informed decision regarding the management of your condition.

What is Involved?

Nail Surgery is carried out at the Clinic, 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 and a half hours is required, with a followup appointment within five days and then again 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 destroy the nail bed and a large dressing then applied. Patients are unable to drive themselves home (insurance is invalid) so need to arrange to be taken home by a friend or relative. Analgesics (Paracetamol) are sometimes required within the first few hours postoperatively.

Is there any Risk Involved?

Yes. These include a possible postoperative infection if advice is not adhered to, 'phenol flare' (localised swelling) where an individual reacts to the chemical used, and on rare occasions there may be small areas of regrowth.

Will the Nail Grow Again?

In all nail surgery procedures carried out, the toenail and nail bed will be chemically destroyed in order to prevent the original problem recurring. In a small percentage (up to 5%) of cases there may be small areas of regrowth where a few nail producing cells remain. Where this occurs it rarely causes problems.