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Nail Surgery Advice

Nail Surgery Advice
Please bring this with you to all appointments

You may need nail surgery due to an ingrown toenail.

An ingrown toenail can often be caused by injury or poor nail cutting. Some people have misshapen nails from birth. Ingrown nails are often associated with increased curvature (involution) of the nail, which causes the nail edge to press into the flesh more easily and this may cause pain and infection.

  • What is involved within nail surgery?

    A local anaesthetic is injected into the affected toe. The anaesthetic lasts a couple of hours and should block pain sensation during the operation. Once the area is numb, a tourniquet is applied to the toe to minimize bleeding.

    Removal of the toenail or part of the nail edge should improve the problem. Your podiatrist will discuss the best operation with you. The chemical phenol may be used to prevent the nail from growing back.

    The total appointment time is typically 1 hour.

  • Are there any risks?

    As with any surgical procedure, there are some risks. Modern local anaesthetics are quite safe, however; there are rare complications such as an allergic reaction or excessive bleeding. Occasionally, the post-operative wound can become infected and require antibiotics. More rarely, further surgery may be required.

    In 5% of cases, the nail may grow back or there may be a mild reaction to the chemical applied to the nail bed.

    Your nail may look different following surgery.

    Please advise the podiatrist of any:

    • Medical conditions
    • Allergies
    • Current medications
    • Previous history of local anaesthetic reaction
    • Possibility that you could be pregnant
    • Holiday/ travel plans
  • Prior to surgery

    On the day of your surgery, you can eat and drink normally.

    Please ensure your feet are clean and remove all traces of nail varnish from your toes.

  • On the day of the surgery

    You should sign the consent form.

    If you are under sixteen your parent or legal guardian (as per consent leaflet) will need to sign as well.

    Bring with you open toed shoes or sandals to allow room for the toe dressing which may be quite bulky.

    It is not advisable to drive after having local anaesthetic and your insurance may be invalid.

  • Post-operative advice

    Directly following the surgery, you need to rest your foot (feet) as soon as possible. To reduce discomfort, you should keep your leg raised for the first few hours and minimise activity for the rest of the day.

    Should you experience discomfort, you can take your usual pain relief as directed on the packet but avoid taking anything containing aspirin. It is important to keep the dressing dry until your next appointment. If the toe bleeds through the dressing put an extra dressing on top but do not disturb the original one.

    Avoid any activities that may injure the toe(s), such as swimming or sports for several weeks following the surgery. Excess pressure on the toe could delay healing.

    Avoid alcohol for the 24 hours following the surgery.

    You should have a review appointment given to you on the day of the surgery. Please keep this appointment.

    After your review appointment, you will start changing your own dressings. Please follow the advice on this webpage.

    If you experience any excessive bleeding or pain, please contact the Podiatry department, your GP or the GP Out-of-Hours Service.

  • Re-dressing your toes

    Your first dressing will be after your review appointment.

    Then follow the below procedure each day for a week.

    Make sure you have the following:

    • Clean bowl
    • Sterile non-adherent dressing
    • Tube gauze (optional)
    • Surgical tape (eg. Micropore)

    (We are unable to supply any of these items)


    What to do:

    • Half fill the bowl with warm water and add a tablespoon of salt
    • Remove the adhesive tape from the old dressing and any parts of the dressing that come off easily. The rest of the dressing will be easy to remove after soaking in the water
    • Immerse the foot in the water for 5 minutes
    • Take your foot out of the water and dry it, avoiding the affected toe
    • Allow your toe to air dry for 2-3 minutes
    • Cover the toe with the sterile dressing
    • If you have to dress another toe on the other foot, repeat the above procedure with fresh water and salt.

    The toe may discharge fluid for up to 12 weeks.

    If you think, you have an infection or have increasing pain or redness please contact your podiatry department for advice.

    Image of foot with dressing around the toe

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