Nail Surgery

Treatment options for ingrown toenails:

-● Conservative management (non-surgical)

●Nail wedge resection (under local anaesthesia)

Andrew set up an additional satellite clinic at another military camp, at Wits Command where nail surgery was also regularly undertaken. In addition, and since 1992, Andrew continues to regularly perform nail surgery as a more permanent solution for problematic, painful ingrown toenails.

-Treatment options for painful ingrown toenails include:

1. Conservative management - this consists of cutting down the side of the toenail (sulcus) in order to remove a painful nail spike. This may be performed during the consultation as a standard consultation. This form of treatment may sometimes resolve the problem, but there are also times when the toenail just grows in again. Should this occur, a more permanent solution will be offered...

1. Nail surgery: A nail wedge resection is performed under local anaesthesia (L.A), as a more permanent solution for a recurring painful, ingrown toenail. (Nail wedge resection with phenolisation of matrix). The procedure is performed in the consultation room in a relaxed atmosphere, and is unrushed. L.A is administered very slowly in order to minimize discomfort.

It is recommended that pain medication is taken directly after the procedure, whilst the toe is still numb, once again to minimize discomfort. Procedures are usually scheduled for times when there is no one else waiting outside for a consultation, hence procedures are not rushed.

Nail surgery includes a follow up review usually 2 days after the procedure. Two more reviews are scheduled a week apart.

In most cases it may be possible to remove a small sliver of nail from the side. The amount of nail removed, however, depends on the severity of the ingrown toenail, the amount of hypergranulation tissue (see definition under causes of ingrown toenails) and curvature of nail sulcus (side of nail). Excessive granulation tissue may need to be excised at the time of the procedure. With nail surgery and phenolisation of matrix there is about 97% chance the offending piece of nail will not return.