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Welcome to Podiatric-Treatment.co.uk |
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| Treatment of Ingrowing Toenail |
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When an ingrown nail does
not respond to conservative care, the best approach for
a permanent cure would be to correct the under lying cause
which in most instances is curved or wide shaped nail
plate. In chronic cases the soft tissue surrounding the
nail plate may be enlarged from constant irritation. Permanent
cure requires surgical treatment. Surgical nail procedures
have improved greatly over the years and in experienced
surgeons hands very high success rates can be achieved.
Basically there are two types of operation:
- Chemical or physical cauterisation
involves removing only the ingrowing section/s of
the nail plate with its root; can be one or both the
sides of the nail plate. To prevent regrowth the nail
root and nail bed is treated using chemical phenol
or sodium hydroxide. The nail root and bed can also
be cauterised using electric, laser or radio wave
energy.
The advantages of chemical procedures
are that they are known for being relatively painless.
There is very little risk of scarring, and so they
also tend to look cosmetically very nice after they
are completely healed. The downside to these procedures
is that they create a minor chemical burn in the area,
so they tend to drain and discharge serous fluid.
Daily soaking and dressing changes are usually prescribed.
- Surgical excisional procedure (Winograd/Frost)
involves cutting/ resecting the offending portion of
the nail plate, one or both sides with attached portion
of the nail root and the bed. With this technique enlarged
soft tissue can also be resected and the incision is
closed using stitches or steristrips.
Compared to chemical procedures, sharp procedures have
the advantage of looking better immediately after the
procedure, and they typically have less drainage and
hence less redressing period. Due to involved cutting,
may create more scar tissue than other types of procedures,
they may have a more noticeable post-operative appearance
and they may hurt more.
Will I require general anaesthetic (be asleep)? And
is it very painful?
Not if you did not want a general anaesthetic. Many
of these procedures are performed perfectly safely and
pain free under local anaesthetic (you are awake). For
very anxious and worried patient after counseling treatment
can be considered under sedation or general anaesthetic
in conjunction with local anaesthetic block. The partial
nail avulsion using chemical ablation (destruction)
rarely causes any significant discomfort. There is slightly
more discomfort with surgical excision, although this
is generally only mild to moderate.
Click here for more information on Podiatry consultants at London Bridge Hospital
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London Bridge Hospital
27 Tooley Street
London, SE1 2PR
Tel: 020 7407 3100
Fax: 020 7407 3162 |
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