Removal Of Ingrown Toenails

Nail surgery can provide a permanent solution to painful thick or ingrown toenails.
Nail surgery is a minor surgical procedure carried out under local anaesthetic to remove ingrown or painful toenails. Once the nail has been removed a chemical can be applied to the nail bed to prevent it from growing back.
The alternative to nail surgery is regular conservative treatment such as cutting back the corner of the nail. This can offer good short-term relief but it is unlikely to provide a permanent solution.

On the day of surgery, please make sure you eat and drink normally before coming to the hospital for your surgery.
You can bring someone with you if you would prefer.
Take all your usual medication (unless told otherwise).
The dressing applied following surgery will be bulky, so bring open-toe footwear.
Arrange for someone to drive you after the surgery because you should not drive with a numb toe

The podiatrist (a specialized health care provider) will check the toe and then inject some local anaesthetic in to the affected toe – this will prevent you feeling any pain during the surgery.
A tight rubber band is placed around the toe to prevent it from bleeding during the surgery.
The ingrown or deformed nail is then removed and the chemical is applied to the nail bed.
The tight band is then removed and a dressing is applied.

The toe will stay numb for 2-3 hours following the surgery; you will need to take care not to injure the toe during this time.
For the remainder of the day, you should sit with your legs elevated to prevent bleeding. It is normal for some blood to show through the dressing, if this happens:
- Do not remove the dressing; simply apply additional gauze on top of the dressing.
- If the toe bleeds excessively, elevate the leg and apply pressure to the toe for 5 minutes.
- If this does not stop the bleeding, seek medical help.
You can return to your normal daily activities the day after your surgery. However, you should avoid sporting activity including swimming until the toe is fully healed.
If you experience pain once the anaesthetic has worn off, you can take simple painkiller such as Paracetamol or Ibuprofen. Do not take Aspirin for pain.

Regrowth: this occurs in about 4% of nail surgeries that use a chemical to prevent regrowth, and 100% of surgeries that do not use the chemical.
Pain: It is usual to get some mild discomfort after the anaesthetic wears off.
Reaction to the chemical or local anaesthetic: Severe allergic reactions are rare. Every effort will be taken to provide you with the best care possible.
Infection: the toe may become infected following the surgical procedure. You can reduce the risk of this by keeping the dressing clean and dry in between dressing changes and by continuing to redress the toe until it has completely healed. Healing usually takes between 4-6 weeks but can be delayed if infection occurs.

Infection may occur at any time following surgery.
Signs of infection to look out for include:
- The toe becoming redder with the redness extending beyond the toe and on to the top of the foot
- An increase in pain, swelling or bleeding or fluid leaking from the wound
- A smell coming from the wound

If you experience any of these or are concerned, please contact the clinic or the Emergency Department for help

Please make sure you attend the redressing appointment given to you by your Podiatrist.
You will be shown how to look after the toe and change the dressing.
In the meantime, you can attend your local wound care clinic where the dressing can be changed.

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