Nail surgery The commonest (and most painful) nail condition is ingrown toenails (onychocryptosis). Ingrown nails can become infected which increases the pain experienced in the area. Ingrown toenails may be a one-off problem or one that recurs with regular frequency. Other painful nail conditions treated by nail surgery include grossly thickened, deformed nails (onychogryphosis) and fungal-infected toenails (onychomychosis). Thickened and fungal-infected toenails can cause great discomfort when pressure is applied from footwear. Some toenail problems can be managed with regular conservative care, however, should these conditions become chronically painful, debilitating or frequently infected, nail surgery is often the best long term and permanent solution. Nail surgery can be performed by Amanda the podiatrist under local anaesthetic. A consent form needs to be filled out. It is a simple and painless procedure that takes under an hour. The nail bed is destroyed with a chemical known as phenol to prevent the problem from recurring in the future. I always strive to ensure that once fully healed the toenail is aesthetically appealing. You will be required to wear a pair of sandals or flip-flops following your surgery as the initial dressing is somewhat bulky. You should also ensure that you arrange for someone to take you home. Following surgery we advise complete rest for 24 hours and, if necessary, take a non-aspirin-based pain killer, such as Nurofen. You will have three further appointments, the first within 24 hours of the nail surgery and the second a week later. During the first you will be shown how to cleanse and redress your toe at home. During the second the podiatrist will ensure that the toe is healing normally and without complication. It is important that you attend these appointments. The third to discharge you after 6 weeks. If there are no complications it takes around 6 weeks for a partial toenail removal (PNA) to fully heal and 8 weeks for total toenail removal (TNA), providing that pressure to the area is minimised by wearing sandals or shoes with adequate depth and width in the toe box area and post operative infection does not occur. There is a slight risk that nail re-growth may occur (around 2% chance) and may require further surgical intervention.
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