An ingrown nail is the ingrowth of the side of the nail plate under the skin. The ingrowth of the nail occurs most often in the area of the big toe. Symptoms of an ingrown nail are pain on the side of the big toe at the edge of the nail, resulting from mechanical irritation and the development of inflammation. There are various treatments for an ingrown toenail. The initial stages can be treated with a special clip placed over the nail by a podiatrist. If podiatry procedures remain ineffective or the degree of ingrown and deformation of the nail is significant, surgical excision of the nail is indicated. The surgical procedure is also used in the treatment of nail injuries and diseases that cause irreversible destruction of the nail plate.
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What does an ingrown nail look like?
How to recognize an ingrown nail? Common symptoms include:
stinging or burning pain at the contact of the nail with the tip of the big toe,
redness, swelling of the big toe,
the sight of "wild meat", pus may ooze from the tissue,
the symptoms worsen when wearing shoes that press on the big toe.
Ingrown nail - causes
The most common causes of an ingrown toenail development include:
pressure of the nail by too narrow footwear,
incorrect nail trimming (trimming the nail corners instead of cutting in a straight line),
incompetent trimming of cuticles, cleaning the dirt under the nail with sharp tools,
mechanical trauma, e.g. a fall of a heavy object on the big toe,
congenital predisposition to abnormal nail growth.
Indications for cutting the nail
Surgical treatment of the ingrown nail is the last resort - it should be performed as a last resort. The indication for cutting the nail is the advanced stage of the disease or the lack of success of conservative treatment in the podiatry's office.
Surgical excision of the nail - other indications
Partial or complete removal of the nail plate is also performed in the following conditions:
large subungual hematoma (e.g. due to trauma),
a foreign body under the nail when it is not possible to evacuate it using conservative methods,
a lesion indicating a neoplastic process,
advanced degree of onychomycosis that cannot be treated conservatively,
large deformations of the nail plate causing inflammation in the absence of podological treatment effects
damage to the nail bed.
The course of the nail removal procedure
The procedure of cutting the ingrown nail is performed under local anesthesia. During the procedure, the patient does not feel the big toe, thanks to which the removal of the nail is completely painless. The surgeon lifts and separates the nail from the placenta - he uses special miniature tools dedicated to mini-procedures. It removes inflammatory granulation tissue and dead tissue under and on the side of the nail. The nail may be removed partially (e.g., only the side of the nail) or completely. In some cases, it is necessary to put on several stitches. Finally, the wound is covered with a dressing. The nail removal procedure takes about 15-20 minutes.
Procedure after surgery
There is no need for hospitalization after the nail removal procedure. The patient may leave the hospital immediately after the procedure, taking care not to overload the limb. It is advisable to arrange transport home. For a few days after the procedure, you should put your leg so that the foot is above the level of the hip. Cold ice packs wrapped in a towel can also be used. This will reduce the swelling and discomfort associated with wound healing. Take medications recommended by your doctor, e.g. an antibiotic. It is advisable to take care of foot hygiene - shower and disinfect the wound with a special wound cleansing agent and change the dressing. During the first week, you must not wet your feet completely while bathing. If sutures are applied during the procedure, they are removed at a medical check-up 10-14 days after the procedure. Regardless, see your doctor if you suspect a wound infection. Symptoms of wound infection are: vivid soreness, increased heat, reddening of the skin, discharge from the surgical wound, and fever. Until the wound is fully healed, shoes should be open or wide-tipped shoes that can easily accommodate the big toe. You should also limit the practice of sports associated with running and sudden changes in running direction.
Important information
|
Duration of the procedure (depending on the method) |
20 - 30 minutes |
| Tests required for surgery | - |
| Anesthesia | Oberst way (injection at the base of the finger) |
| Hospital stay | - |
| A period of significant dysfunction | - |
| A period of limited dysfunction | 2 - 3 days |
| Removal of stitches - first visit | 7- 10d days |
| Change of dressings | daily |
| Contraindications to the procedure | anticoagulants |
Frequently asked questions about the removal of the ingrown toenail:
Ingrown nails can be treated conservatively with a special clamp placed by a podiatrist. Surgical excision of the ingrown nail is performed in the case of very advanced lesions and in the event of failure of podological treatment. It is a safe and completely painless procedure, but it involves a temporary loss of part or all of the nail plate. After the treatment, the nail gradually grows back.
The toenail grows to its full length, usually 12-16 months after its removal.
You can walk right away after the nail removal procedure. Due to the fact that a dressing is put on the toe, it is necessary to have open shoes or boots with very wide tips. However, long-term walking should be avoided until the stitches are removed (10-14 days). The foot should be kept above thigh level as often as possible and cold compresses should be applied.
