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What is
Toenail Removal?
Your toenail can cause trouble in two main
ways. First, it can make the skin fold at
the side and become very swollen and red (ingrowing
toenail). Second, it can become very thick,
curved and painful. Both these conditions
can be treated by an operation.
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Effects
of Toenail Removal
With this
procedure, the entire nail or only the
portion of the nail growing into the skin
may be removed. It is most often performed
for the following reasons:
·
To relieve
pain
·
To relieve
swelling (inflammation or infection)
·
To remove a
deformed nail
-
To correct abnormal nail growth
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Candidates
for Toenail Removal
Toenails may need to be removed because of
injury or nail infection. The nail may also
need to be removed if it is not growing
correctly. This may be called an ingrown
toenail. This usually happens when the
toenail grows into the tissue or skin of the
toe.
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Your
Consultation
Check you have a relative or friend who can
come with you to the hospital, take you
home, and look after you for the first week
after the operation. Bring all your tablets
and medicines with you to the hospital. On
the ward, you may be checked for past
illnesses and may have special tests, to
make sure that you are well prepared and
that you can have the operation as safely as
possible.
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The Toenail Removal
Procedure
The toe is made numb with an injection of
local anaesthetic into its base. Then, for
an ingrowing toenail, a sliver of the nail
and of the nail bed is cut out on each side
that is tender and swollen. The nail is then
always a little narrower. The skin fold
settles down. For a thick curved nail, the
whole nail and all the nail bed are cut out
so that instead of a nail there is just
skin.
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Recovery
There is no feeling in the toe for an hour
or so. After this you may need painkillers
such as paracetamol, to control any pain.
This gradually improves after a day or so.
You should be able to eat and drink
normally. The wound has a dressing which
should not be removed for one week. You will
need shoes with a large area for your toes
to accommodate the bandages, or shoes with
no toes. Keep the dressing dry and as clean
as possible. There may be stitches in the
skin. Wash around the dressing to avoid
wetting it. Some hospitals arrange a
check-up about two weeks after you leave
hospital. You should be able to return to a
light job within 24 hours and a heavy job
within three weeks.
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Risks
Complications are rare and seldom serious.
If you think that all is not well, ask the
nurses or doctors. Bleeding in the first 12
hours may be troublesome. Apply pressure
with a bandage on the toe wound and contact
your doctor straight away. Pain in the toe
that cannot be controlled with simple
painkillers, or pain that is bad enough to
keep you awake, means you should contact a
doctor. The wound is tender and delicate for
a week or so after the dressings are taken
off. This rapidly gets better. There is also
a very small chance of infection, which can
be controlled by taking antibiotics for a
few days. The chance of the nail trouble
coming back is about 1 in 20.
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Frequently Asked
Questions
Q: What happens during the toenail removal
procedure?
A:
For the
operation, you will be lying on an operating
table. The anaesthetic injection will be
given into your toe. This is uncomfortable,
but the feeling soon wears off. Your toe
will be cleaned with antiseptic, and sterile
towels will be draped around it. A tight
band will be clipped around your toe to
prevent bleeding. The operation is
performed. This takes about 15 minutes per
toe. The toe is covered with a dressing and
a bandage to apply gentle pressure on the
wound and to prevent any bleeding.
Q: Are there any alternatives to toenail
removal?
A:
If you leave
things as they are the trouble with your
toenail will stay about the same.
Antibiotics can be helpful, especially when
the area that is swollen and painful is
infected. However, if you don’t have any
other treatment, the infection might very
well come back. Taking off the nail and
letting it re-grow does not give good
results. Killing the nail bed with Phenol is
sometimes used. Taking away the whole nail
bed is needed only if the whole nail is
diseased.
Q: Is the procedure painful?
A:
Most patients report no pain during the
procedure once the anesthetic has been
given. But injection of the local anesthetic
can be painful; this discomfort can be
reduced by careful administration by your
doctor. [Anesthetic injection into toes or
fingers are usually quite painful due to the
tight skin and many nerve endings. Spraying
with a topical anesthetic spray first before
the injection may help or perhaps some
anesthetic preparations may be less
irritating than others—so the doctor can
reduce the discomfort somewhat.
Q: How can I avoid future ingrown nails?
A:
Do the following to prevent having ingrown
nails:
·
Do not wear high heels or shoes that fit
poorly
·
Trim your toenails straight across and do
not pick or tear at them
-
If you have diabetes, consider letting a
podiatrist or other health professional
trim your nails
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