An ingrown toenail is one where the side or corner of the nail curls and grows into the skin of the toe. It may be caused by ill-fitting shoes, injury or improperly cut nails. Patients present with redness, swelling, and pain at the involved site around the nail. Surgical options for ingrowing toenails must be individualized based on the nail condition, the extent of disease and the medical condition of the patient. The ingrowing of the toenail is most common for the big toenail, but it can happen to any toenail.
Ingrown toenail surgery may be recommended if:
Part of or the entire toenail may need to be removed, depending on the situation. Avulsion of the nail plate is the most commonly performed surgery. It can be used as adjunctive therapy in long-standing nail infections (bacterial and fungal) and trauma-induced nail changes. The paring of the nail plate is another treatment option where pieces of the nail plate are removed longitudinally to visualize the underlying nail bed.
After a numbing injection to the toe, using scissors and other instruments the nail plate is separated from the nail bed and vertically the ingrown side is cut out till the cuticle. If necessary, the entire nail plate may be removed, especially if both sides of the nail are ingrown. Electro or chemical cautery using an acidic solution like phenol, the nail matrix is disrupted. Also, it stops the bleeding. That portion of the nail most likely would not regrow. In the end, the operated area is bandaged after applying an anti-bacterial cream.
Oral antibiotics and pain killers are given to relieve pain and to prevent infection. The patient is advised to rest, limited movement of the toe and foot end elevation.
Open-toed shoes are preferred for two weeks post-surgery. This gives room to the nail for faster healing. Most of the patients resume their regular activities in a few days.