Removal of an Ingrown Toenail

If you recently had an ingrown toenail removed by Dr. Campitelli, the following instructions will help guide you through the process of healing after the procedure.

Procedure type

There are two types of procedures which can be performed on an ingrown toenail- a nail allusion and a matrixectomy.

 Nail avulsion

A nail avulsion is performed to remove the incurvated portion of the nail plate temporarily, and allowing any infection to drain from the area. This is usually performed in acute situations when the infection is too severe to perform a permanent procedure or if this is the first time the nail plate has ever been infected.

 Matrixectomy

This procedure is reserved for instances where the ingrown toenail continues to reoccur and a permanent fix is needed. The cells which turn into the nail plate are ablated with the use of chemical compound phenol. This chemical burn stops the growth of the side of the toenail that was removed, or in more severe cases, the entire toenail. Dr. Campitelli would have discussed how much of your nail is being removed prior to the procedure. Sometimes matrixectomies are performed to remove an entire toenail that is severely deformed and painful.

Treatment Post Operatively

After your procedure, you will be discharged home in a gauze bandage with a surgical shoe or your own open toed shoe (patients typically prefer to bring their own open toed shoe as opposed to using a surgical or post op shoe). This initial bandage stays on for 24 hours to control bleeding and swelling. It is perfectly normal to see any bleeding through this bandage so do not worry if bleeding is seen. Your instructions will say to keep this bandage on for 24 hours before beginning soaking and dressing changes. It is perfectly fine to remove the bandage the morning after your surgery even if it has not been a full 24 hours and begin soaking.

Soaking Instructions

Soaking is typically performed in warm water with any of the following:

• Capful of epsom salts (not a cup!)
• Antibacterial soap
• Betadine solution 1-2 tablespoons

What works the best? They all work well.  Recommendations are use whatever is available in your house. If you have to make a trip to purchase something, betadine is preferred solution.

On your first post operative dressing change, it is advised to soak first before removing the bandages. This will help to loosen and bandages they may be adhered to the wounds minimizing pain.

You should soak your foot 20-30 minutes twice a day to keep the wounds clean. This should be performed for 2-4 weeks after surgery. Nail avulsion typically will be resolved in 2 weeks, and matrixectomies can take up to 4 weeks or even longer. When the wound(s) are healed, soaking is no longer necessary.

Nail avulsions whether a partial or total will typically heal within 2 weeks. Patients are usually allowed to return to normal physical activity within 24-48 hours post procedure. Even runners can resume running within 24 hours after the procedure if they feel comfortable doing so.

Matrixectomies can take longer to heal from then nail avulsions. Remember, a chemical burn is being created to stop the nail plate area from growing back. This area will drain and look red or irritated for sometimes up to 2-4 weeks. This is completely normal. Dr. Campitelli will have an appointment scheduled to see you 2 weeks after your nail surgery so if you are concerned, he will be looking at it again to answer any questions and make sure healing is occurring.

Infection

While it is very rare for infection to occur after an ingrown toenail procedure, it can happen. Signs of infection can include any of the following:

• Redness extending in a large area around the wound(s)
• Pain that is not resolving 5-7 days after surgery
• Thick yellowish drainage that is not clear from the wound(s).
• Fever, chills, or flu like symptoms
  

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  If you experience any of the above signs or symptoms, please call the office at 330-926-3231 and have Dr. Campitelli paged.