An ingrown nail (called Onychocryptosis) is a painful condition where the toenail is growing in either an excessivley curved or an excessively flared direction into the skin at the nail edges. This causes a significant amount of pain and often associated infection requiring the nail edge to be removed.
If the ingrown nail problem is recurrent, the most appropriate definitive procedure is to remove the nail edge of the toenail and the cells where the nail starts its growth (called matrix cells) as it is either damage or a congenital problem with these cells that dictates the pattern of nail growth.
The procedure is undertaken under local anaesthetic. A small and quick injection of local anaesthetic is administered by the podiatrist into either side of the nominated toe to completely numb the entire toe.
The foot is then prepared under sterile conditions for the procedure.
The procedure involves removing the offending nail edge including the matrix cells with sterile instruments.
The podiatrist will then apply a chemical called Phenol down the side of the toe into the small pocket where the matrix cells were to kill any remaining cells, should they exist. This will reduce the chances of regrowth to a very low percentage.
You will need to bring open-toed shoes as you will have a dressing on the toe for 2 days that will not fit into closed shoes.
The podiatrist will initially dress the area with an antiseptic, non-adherent dressing and tubi gauze to hold the dressing in place.
The area is an open wound and must be treated with care, therefore the initial dressing must be left on and kept dry until you next see your podiatrist as it ensures the area is kept completely sterile and clean, reducing the chance of infection.
You will be able to walk and function normally. You will be advised to keep your feet elevated and rested on the day as much as possible. There will be some discomfort so it is advisable to take simple analgesia such as panadol or panadeine before the local anaesthetic wears off, your podiatrist will advise you of appropriate pain relief.
Your podiatrist will provide a post-operative handout informing you of post-operative care and it is esential that you follow these instructions to ensure healing takes place problem-free.
You will generally see your podiatrist for the 1st dressing change where the bulky dressing will be removed and the wound cleaned to ensure no infection is occuring. You will then continue redressing the wound yourself as per the post-operative handout.
Your podiatrist will request a review approximately 10 days later to ensure healing is occuring as expected and you will be required to continue dressing the until healing is complete.