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Nail Surgery

When may nail surgery be necessary?

Some toenail problems can be managed with regular conservative care, eg our laser treatment of fungal nail infections, however, should these conditions become chronically painful, debilitating or frequently infected, nail surgery is often the best long term and permanent solution.

The commonest (and most painful) nail condition that we encounter at The Letchworth Clinic is ingrown toenails (onychocryptosis). These are often caused by poor cutting techniques or awkwardly shaped (involuted) nails. 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. Patients often find they are unable to wear their normal footwear and participate in sports as the pain is too great, especially if the toenail is infected.

Other painful nail conditions treated by nail surgery include grossly thickened, deformed nails (onychogryphosis) and severe fungal-infected toenails (onychomychosis). Thickened and severe fungal-infected toenails can cause great discomfort when pressure is applied from footwear.

If nail surgery is necessary it can be performed by our experienced podiatrists under local anesthetic. It is a simple and painless procedure that generally takes under an hour. The nail bed is destroyed with a chemical known as phenol to prevent the problem from recurring in the future. We always strive to ensure that once fully healed the toenail is aesthetically appealing.

Nail surgery procedure:

You require 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 paracetamol.

You will have two redressing 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.

If there are no complications it takes around four weeks for a partial toenail removal (PNA) to fully heal and six 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 regrowth may occur (around 5% chance) and require further surgical intervention.

More information about nail surgery complimentary therapies we offer here at the clinic:

LCN toenail reconstruction:

We now also offer LCN toenail reconstruction, click here for more information.  This treatment is ideal for those who are missing nails due to nail surgery or nails that have had partial regrowth following nail surgery.

Treatment of fungal nail infections:

At the clinic we now offer the most up-to-date and effective method of treating the fungus which affects the toenails with our Cutera 1064 Nd:YAG laser.  Click here to find out more information about this treatment method.

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