Nail surgery
Nail surgery
Nail surgery is a long-term solution for problem nails that have not responded to other treatments. The Nail Surgery team can help with a range of painful and problem nails, including infected in-growing toe nails.
Nail surgery is a minor surgical procedure to remove all or just part of your problem toe nail. Before you are booked in for a nail surgery procedure you will have an assessment appointment with a podiatrist to check that nail surgery is suitable for you.
On the day of the nail surgery, your toe will be numbed with local anaesthetic. Once the nail has been removed, a chemical will usually be put on the nail bed to stop the problem nail growing back again.
You may have your nail surgery procedure at either Horton Park, Keighley, Skipton, Shipley or Woodroyd health centres.
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Will it hurt?
Your podiatrist will numb your toe with a local anaesthetic so that you cannot feel the nail or part of the nail being removed. However, the anaesthetic injection may sting for a few minutes.
Will I need an injection in my toe?
You will need a local anaesthetic injection in your toe to numb it.
Can I eat and drink before the procedure
You can eat and drink normally before you attend your appointment for the nail surgery.
What do I need to bring with me?
You will need to bring any medication you take – especially inhalers for asthma, GTN spray for angina. Also bring loose fitting footwear for example sliders or open toed sandals as you will have a large dressing on your toe afterwards.
Can I drive on the day?
We advise you to take alternative transport home as you will have had a local anaesthetic in your toe and it will be numb.
How soon can I go back to work/school afterwards? How much time do I need to book off work?
It’s best to rest after your nail surgery to reduce pain and the risk of bleeding when you get home. You will also need to rest your foot for at least a day after the surgery to help it to start to heal. If you have a very active job, or have to wear special footwear for your job, discuss with your podiatrist at the pre-op assessment appointment about how long you will need off work afterwards.
How long will my toe take to heal? (6-8 weeks)
If you generally heal well, it should take 6-8 weeks to fully heal a partial nail removal and up to 12 weeks for a total nail removal.
Will the nail grow back afterwards?
A chemical called Phenol is used on the nail bed after the nail/part of nail is removed to prevent the problem nail growing back.
What will my toe look like when it’s healed?
Many people wonder what their toe will look like at various stages of healing. Take a look at some photos.
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How long will my toe hurt for afterwards?
People have reported that the discomfort is minimal afterwards and can be controlled with pain medication such as paracetamol or ibuprofen.
What do I do if there’s blood on my dressing when I get home?
Do not take off the dressing your podiatrist has put on. Put a new dressing over the top and sit with your foot elevated for the rest of the day.
How soon do I put a new plaster or bandage on my toe?
You will need to remove the dressing your podiatrist put on your toe after the surgery after 5 days, clean your toe, and then put the clean dressing on your toe that your podiatrist gave you.
How long do I need to keep dressing my toe?
You will need to redress your toe every 3-4 days until your toe is healed.
How long must I keep the wound dry for?
You will need to keep your toe dry for the first five days (especially while washing/showering), Then after five days you can remove the bandage and bathe as normal, getting to toe wet. This should help to cleanse the wound and then dry and apply a new fresh dressing. This should be done every 3-4 days until the toe has healed.
How will I know if its infected?
If your toe is hot, red, swollen, with pus, it may be infected and you will need to talk to your podiatrist or GP as soon as possible.
Who do I contact if I think its infected?
Please phone 01274 221165 between 9.00am-4.00pm, or if it is out of those hours, contact your Out of Hours GP Service.
Where can I buy dressings from?
You will be given a starter dressing kit to take home with enough dressings for one redressing. You will need to buy more dressings from your chemist, or from an online provider, so that you can keep redressing your toe to keep it clean and dry and help it to heal.
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It may take a while before your toe looks ‘normal’ again – don’t let this worry you. The photographs below give you an idea of what to expect from five days to six weeks after nail surgery.
If you have had a full toe nail removal – these photographs show you what you can expect when your toe is fully healed.
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After nail surgery, you need to take special care of your toe/s over the next 4-8 weeks. The open wound on your toe/s can become infected if not cared for properly as the break in the skin provides a route for germs to travel inside the wound. Skin acts as a barrier. Taking extra care of your toe/s will help to minimise risk of infection, prevent a delay in healing and reduce discomfort or scarring.
Preventing infection
Keeping a dressing on your toe whilst healing will help reduce the risk of getting an infection. Wounds heal better if they are kept covered and dressings are not changed too often. If you change the dressing too often the wound heals more slowly as it cools down, dries out too quickly and is open to risk of infection.
Change the first dressing five to seven days after your surgery. Then change your dressing every three days. Keep your toe/s covered until you get two dressings with no discharge on them.
You should also keep the dressing dry. If you get your dressing wet/dirty, then it will need to be changed straight away.
Problem signs to look out for
If there is swelling, the skin feels too firm or appears red, dark or ‘squishy’, if there is heat, pain or pus, please contact your GP as you may need antibiotics.
You also need to be aware of Phenol burn. Phenol is the chemical used to destroy nail cells so that the problem nail can’t grow back again. It can spread to surrounding skin which can delay healing. If the toe is painful, please take your usual pain relief.
Footwear whilst your toe is healing
Wear suitable footwear while your toe is healing. If your toe is uncomfortable, it might mean that your shoes are too tight and you need to wear socks/footwear with more room around the toes.
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To change your dressing you will need some warm tap water, a clean cloth or gauze to clean and dry your toe, and some tape to hold the dressing in place. You will also need a clean, dry, nonstick dressing – the podiatry team will give you a starter pack of Softpore dressings and you can buy more from a pharmacy if needed.
Remove your old dressing
You may need to soak your old dressing in warm water to remove it if it’s stuck. Don’t pull it, use the water to release it gently. It’s important not to poke, pick or prod the wound.
Clean your toe
Once you have removed your old dressing, clean your toe with a clean cloth or gauze and ensure it is dry.
Unpack the softpore dressing
Take the dressing out of the pack.
Cut two slots in the dressing
Using a clean pair of scissor, snip the sticky part of the dressing on one side up to the padded piece.
Place the dressing on your toe
Ensure the pad covers your nail area so the sticky pieces can be folded around and on top of the toe.
Fold the dressing around your toe
Fold the dressing around each side of your toe, then stick down the centre piece (between the two slots you cut) over the top of your toe, then stick the left and right sides over your toe (see the video above if you are unclear).
Your dressing has been changed
That’s it – all done.