Ingrowing toe nail

What is excision of an ingrown toe nail?

This is a procedure where either a wedge of the ingrown nail or the entire nail is removed and the nail bed is treated with a chemical (phenol) to prevent the nail from growing back.

Type of procedure

This is a day case procedure and same day discharge is usual.

Type of anaesthesia

The operation will be undertaken under a local anaesthetic. This involves an injection around the big toe (also called a ‘ring block’. The effect of this block will last for a few hours after surgery.

How long will the surgery take?

The surgery normally takes about 10 minutes.

Risks of surgery:

This is a procedure with minimal risks. The commonest being a recurrence of an ingrowing toe nail which may require further surgery. Risk of this is <2%.

Recovery from surgery

What can I expect immediately after the surgery whilst in hospital?

It is normal to have numbness in the operated toe as the anaesthetic block will take a few hours to wear off. You will have a bulky dressing to your foot.A stiff sole shoe will be provided in which you can walk after surgery. You will also be given painkillers to take home. It is normal to experience moderate pain after surgery and you can keep this to a minimum by taking regular painkillers. You can go home within half an hour after surgery, as it is a day case procedure.

Specific recovery protocol:

Day 1 - 7

  • Foot wrapped in bulky bandage and surgical stiff sole  shoe
  • Allowed to walk in a stiff sole shoe
  • Take pain medication
  • Expect numbness in foot 12-24 hours then moderate pain
  • Bloody drainage through bandage expected.
  • Do not change bandage.

Day 14

  • You will have a follow up visit in clinic
  • Your wound will be inspected. You will have sutures so they need to be removed
  • You will be discharged from clinic at this stage with advice to get in touch with us if there are any concerns in the future

 

Post operative clinic visit schedule

2 weeks after surgery -  wound check, suture removal and a view to discharge from further follow up


When can I begin to walk?

You are allowed to walk in a stiff sole surgical shoe on the day of surgery. You can graduate to normal shoes after 2 weeks when the wound has healed.

 

How do I look after my surgical wound site?

Your wound should be healed 2 weeks after surgery. If you notice any redness around the wound site, get in touch with your consultant as you may have a wound infection. Do not pick on any scabs and allow them to fall off.

 

How do I shower or wash?

Do not get your wound wet until it heals completely. You can use a waterproof cover or plastic bag over your foot when you have a shower. Only expose your wound to water after it has healed completely.


When can I get back to driving?

It is the responsibility of the driver to ensure that he/she is in control of the vehicle at all times. As a general rule, you are ready to drive when you are able to perform an emergency braking manoeuver without pain. This usually is 1 week after surgery.

Click here to read the guidance from the DVLA on driving after surgery.

 

When can I get back to work?

Returning to work is very much dependent on the specific type of job and individual. As a rule of thumb -

  • Office based sedentary work - 1-2 days after surgery
  • Manual labour  - 2 weeks

 

When can I get back to sport?

As soon as your wound heals. As a rule of thumb, give yourself 2 weeks.

 
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