Preparing for Nail Surgery and Your Aftercare

Information for patients

For more information about our Trust and the services we provide please visit our website: www.nlg.nhs.uk

Preparing for Nail Surgery and Your Aftercare Name: _______________________________ Who to contact and how: _______________________________ Notes: _______________________________ _______________________________ _______________________________ _______________________________ Diana, Princess of Wales Hospital Scartho Road Grimsby DN33 2BA

03033 306999 www.nlg.nhs.uk

Scunthorpe General Hospital Cliff Gardens Scunthorpe DN15 7BH


Goole & District Hospital Woodland Avenue Goole DN14 6RX




Your Nail Surgery May Take Place: At either:

Scartho Medical Centre, Springfield Rd, Grimsby DN33 3JF

or

Ironstone Centre, Teale St, Scunthorpe DN15 6EG

What is Nail Surgery? Nail surgery is the removal of all or part of the toenail. This is done when a patient is suffering from one of a number of conditions that cause ongoing pain / discomfort and / or infections. After either a partial or a total nail removal a chemical is applied to the exposed nail bed to prevent the nail from growing back. Healing takes between 4-8 weeks for a partial nail avulsion (removing part of the nail) and between 6-12 weeks for a total nail avulsion (removing all of the nail) but can take longer in some cases.

Before After

What are the symptoms post nail surgery? When the anesthetic wears off the toe may be uncomfortable and the toe may continue to bleed for a short time when you get home. You may wish to take paracetamol but it is best to avoid aspirin as this could reduce the clotting ability.

Why do I have this condition? Involuted (curved shape) nails can be inherited traits and if looked after correctly shouldn’t cause great problems. Ingrowing toenails can be caused by incorrect cutting of nails and the wearing of incorrect footwear causing pressure to the toes.

Thickened nails can be due to trauma and or fungal infections.

How is it managed? The management of any nail condition can be achieved either by conservative treatment with a HCPC registered Podiatrist (in the case of ingrowing toenails normally conservative treatment works best if the condition is dealt with in the early stages) or the use of nail surgery.



Why am I having this operation / treatment? Nail surgery has been recommended as conservative treatment either has been tried and failed, or with the condition that you have conservative treatment would be considered inappropriate at that time.

What are the benefits and risks to me? The benefits of nail surgery are a reduction of pain and a long term solution. Nail surgery is known to be very safe and effective; however no operation can guarantee success all the time.

In rare cases the following may occur:

Nail Regrowt h – every step is taken to prevent the regrowth of the nail, however there is a small percentage (5%), where regrowth occurs.

Delayed Healing – healing can be slow and can depend on your age, health, how quickly your skin takes to heal and how you look after your toe.

Infection of the Wound – this may present itself as a red, hot, inflamed, painful toe. A swab may be taken to ensure infection is present and that it is treated with the correct antibiotics.

Bleeding and Bruising – bleeding may occur after nail surgery. It is important to keep the foot elevated and rest for the remainder of the day.

Allergic Reaction – anaphylaxis is a severe allergic reaction. It is a risk, although it is rare and highly unlikely.

Pain – in very rare cases, prolonged pain can be experienced. Most cases of Complex Regional Pain Syndrome are triggered by an injury and the resulting pain is more severe and long-lasting than normal.

Due to anxiety of having the procedure patients can sometimes feel agitated, feel dizzy or sick and in rare cases loses consciousness.

Is there anything else I should know? On the day of the surgery:

• Please take bath or a shower

• Please remove all traces of nail varnish

• Do not drink alcohol

• Eat a normal light meal before the surgery

• Take any medication as normal unless advised otherwise by either the podiatrist who did your assessment or your GP / consultant

• Bring suitable footwear that will fit over a bulky dressing



• Directly after the surgery it is important to get home and rest. To reduce discomfort you should keep your leg elevated for the first few hours, this helps the blood to clot. Take it easy for the rest of the day

• Should you experience discomfort you can take your usual headache relief tablet such as paracetamol. Avoid taking aspirin

• It is important to keep the dressing dry and in place until your next appointment

• If the toe bleeds through the dressing, add an extra dressing on top but do not remove the original one

Popular Questions Asked by Patients Will I be able to drive after the surgery?

It is not advisable to drive after surgery as your toe will be numb and your insurance may be invalid; meaning you are not covered if you had an accident.

How long will it take to heal?

Healing can be slow and can depend on your age, health, how quickly your skin takes to heal and how you look after your toe. This can vary between 4 and 12 weeks on average, it could be longer in rare cases.

When can I go back to school / work?

Directly after the surgery it is important to get home and rest. Normally it would be safe to resume normal activities the following day; but refrain from activities like sport that may injure the toe. Excess pressure on the toe will delay healing. In the case of people who use steel toecap boots so long as the toebox doesn’t press on the wound should again be able to resume work after first redressing.

How long will my toe be numb for and will it be pai nful when the anaesthetic wears off?

The anaesthetic will last for 2-4 hours. You may experience some discomfort following this. If you do require painkillers then take them as directed on the packet. Avoid anything containing Aspirin.

What happens when I go home?

When you go home Keep the dressings dry and in place until you go for your first redressing appointment (normally about 1- 3 days after the surgery).

If the wound does bleed through the dressing do not remove the dressing but add further dressings over the top. Sit with your foot and leg elevated – onto a stool. If that still doesn’t help you may need to attend A and E.

The toe may look inflamed and wetter than normal after about 2-4 weeks this is due to a possible phenol flare. That is your body’s reaction to the phenol (the chemical used to prevent nail from regrowing) and is perfectly normal and should settle down quickly.



If You Suddenly Suffer from Any of the Following:

• Sudden increase in pain

• Toe getting very hot to the touch

• Redness

• Swelling

You Should See Your GP Regarding Possible Antibioti cs as These Could Be Signs of an Infection Do not use any antiseptic creams or solutions that have not been advised by the podiatrist as this may affect the healing process.

Redressing Your Toes: This should be done every day.

Make sure you have the following:

• Clean bowl, warm water and a tablespoon of salt per wash

• Sterile non adherent dressing (Softpore, Cosmopore, Melolin and surgical tape or similar)

What to Do:

• Half fill the bowl of warm water and add the salt

• Remove the dressing if comes off easily, otherwise soak off in the water

• Immerse the toe in the water for 1-2 minutes

• Dry around the toe and then allow to fully air dry for 2-3 minutes

• Cover the toe with the sterile dressing

The toe will continue to discharge for up to 12 weeks; this can be a pale to straw coloured discharge and is normal part of healing. You will receive regular dressing appointments until the podiatry team are happy that your toe is healing.



If you experience any excessive bleeding or pain pl ease contact either the podiatry department, your GP or your local minor Injury Unit or A and E.

Please take this leaflet with you:

PROCEDURE:

ANAESTHETIC: Mepivicaine 2% Plain

Site:

Quantity:

DATE:

For Further Information Contact: Your local podiatry clinic. Local Clinic Tel No…………………………………..

The Society of Chiropodists and Podiatrists.

www.feetforlife.org

Dates

Appointments: …………………………………………….

Pre Op Assessment …………………………………………….

Nail Surgery Procedure …………………………………………….

First Redressing …………………………………………….

Any Comments, Compliments, Concerns or Complaints If you have any other concerns please talk to your nurse, therapist or doctor. Our Patient Advice and Liaison Service (PALS) are available on 03033 306518 (Grimsby, Scunthorpe and Goole). You can also contact [email protected]

As a Trust we value equality of access to our information and services, therefore alternative formats available on request at [email protected]

Date of Issue: July, 2019

Review Period: May, 2022

Author: NLaG Podiatry Nail Surgery Team

IFP-0327 v2.3

© NLGFT 2019

Documents

Preparing for Nail Surgery and Your Aftercare