What is ingrown toenail surgery and how is it done?
There are many procedures that have been developed over the years to address chronic or recurrent ingrown toenails. These range from quite invasive procedures requiring stitches and considerable change to the visual appearance of the toe and nail, to less invasive procedures with minimal post operative pain and less cosmetic effects.
At The Ingrown Toenail Centre our preferred procedure for ingrown toenails is a partial nail excision and chemical matrixectomy done under local anaesthetic. This has been shown through research to be the most reliable form of procedure to reduce the risk of recurrence caused by a regrowth of the nail. Nail surgery is generally very safe, with very minimal pain afterwards, and can be safely performed in an office based clinical setting.
This procedure involves removal of the outside edge of the nail, with the associated area of nail root (matrix), and treatment of the area where the nail root is located with a chemical (phenol) to destroy the cells which are responsible for nail growth. It is done under a local anaesthetic toe block, which means there is no discomfort during or immediately after the procedure, and you can return home directly afterwards. Cosmetically, the nail plate will look slightly narrower once fully healed, and this is usually barely noticeable.
After the procedure, you will be sent home with the toe bandaged and instructions on what to do (pain medications, elevation, rest, keep dry, etc). Typically, your podiatrist will review you within a couple of days and change the dressing, and then given you instructions on self management of the toe (ie changing dressings yourself) over the coming 1-2 weeks. Your podiatrist will then normally review the toe again at that point to make sure it is healing properly, and then follow up with you as necessary after then.
Who is suited to having ingrown toenail surgery?
Most sufferers of chronic ingrown toenails will be suitable for the procedure, however there are some situations where this may not be appropriate. This includes patients with medical conditions where there is poor circulation in the foot, certain medication treatments, or if there are other health problems you podiatrist feels may affect your ability to recover suitably from the procedure.
What if I am ‘needle-phobic’ or anxious about medical procedures?
We understand that some people can be very worried and anxious about having minor surgery under local anaesthetic. If you are ‘needle-phobic’ or suffer from anxiety about the procedure, we are able to provide you with some sedation to reduce your stress and concerns. We commonly use Penthrox (“the green whistle”) which can be inhaled immediately prior to, and during the injections to calm you for the procedure. An additional fee applies to the use of Penthrox sedation.
Alternatively, we can prescribe a dose of a benzodiazepine (like Valium), which is a tablet that can be taken about 1 hour prior to the procedure. A responsible adult will be required to drive you to and from the procedure in this circumstance.
Please contact us if you are worried or concerned about having injections, or the procedure in general, and talk to one of our friendly podiatrists about your sedation options.
What are the benefits and risks?
The principle benefit of ingrown toenail surgery is to provide a permanent solution to chronic pain, discomfort or infection affecting the toe. Left untreated, chronic ingrown toenails can in some circumstances lead to severe infections, affecting the toe bones and causing a deep infection known as osteomyelitis, which can be very difficult to treat.
No surgical procedure, no matter how large or small, is without risk.
The most common issues that may occur following ingrown toenail surgery are infection, recurrence or delayed healing. Typically, the chance of developing any of these problems with ingrown toenail surgery is very small, and measured at only a few percent of all surgical cases in healthy individuals.
Because of these potential risks, our podiatrists will explain and discuss these issues with you, and ask that you complete a consent form to indicate you are aware of these risks before we undertake care of your ingrown toenail.