Nail surgery pre-operative advice

Consent

In order to comply with the law regarding consent, a person having legal parental responsibility must accompany a child under the age of 18 years (biological parent or person with a court issued order). If english is not your first language and you need an interpreter please let us know at the time of booking your appointment so this can arranged.

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What happens after surgery?

Do not drive, walk or use public transport to get home. Alternative travel arrangements should be made prior to the surgery being done. 

You will be advised to go home directly after the operation and to rest with your foot elevated for the remainder of that day.

Do not drive for at least eight hours following the administration of the anaesthetic – this is due to the local anaesthetic.

You must book a follow up dressing appointment at your registered GP surgery with your practice nurse two to three (not within 24hrs) days after your procedure.

The nurse may wish to see you for further appointments after this depending on the progress of the wound.

If you have any questions of queries, please do not hesitate to contact the podiatry department on dhc.podiatry.enquiries@nhs.net

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What is nail surgery?

Nail surgery is a surgical procedure used to treat problematic and ingrowing toenails. A local anaesthetic is given to numb the toe and a tourniquet (a rubber ring to temporarily prevent blood flow) will be placed over the toe that is being treated. Part of the problem nail or the whole nail can be removed.

Following removal, a chemical (liquid phenol) is applied to the nail bed to prevent the part of the nail that has been treated from growing again. Please allow roughly one hour for the procedure.

Which nails may be treated?

Some examples of nail conditions that may be treated by nail surgery:

  • ingrowing toenail where the nail breaks the skin
  • an infected ingrowing toenail should be treated with antibiotics as needed until time of surgery
  • thickened nails.

Is the surgery going to hurt?

You may feel some discomfort during the injection of the local anaesthetic, but no pain should be felt during the procedure.

If there is any pain, more anaesthetic can be given. When the anaesthetic wears off you may experience a throbbing pain, if this happens take what you would normally take for a headache (but avoid aspirin)

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What are the possible risks?

As with any surgical procedure there are some risks. In nail surgery these include the following:

  • infection following the removal of the nail/ nail piece
  • a local reaction to the chemical applied to the nail bed
  • regrowth of the removed nail/nail piece
  • distortion of the remaining nail following partial removal
  • a rare but serious allergic reaction (anaphylaxis) following the injection of the local anaesthetic.

Your medical history and/or medication can put you at increased risk – your podiatrist will be able to advise you individually about this, e.g., if you have diabetes you are more at risk of infection and/or poor healing after the procedure

Before surgery

Your podiatrist will carry out a full assessment. Please inform the podiatrist of all medication you are taking and give details of all your previous medical history.

Do not take additional medication unless instructed to do so. Bring your inhalers/sprays with you to your appointment; nail surgery may not go ahead without these.

If you are waiting for another operation tell the podiatrist; nail surgery may be postponed if necessary. If you are pregnant/ may be pregnant or breast-feeding inform the podiatrist; the procedure may need to be modified. A local anaesthetic is used – you can eat and drink as normal.

You should not have any other local anaesthetic (e.g., from your dentist) within 24hrs of your nail surgery appointment. A loose slipper, open-toed sandal or similar footwear should be brought to accommodate the initial bulky dressing. Please remove all nail varnish prior to attending nail surgery. No food or drink should be consumed during the procedure.

Would I need time off work/ school?

You will have a large bandage on your toe after the procedure and will be unlikely to wear your normal footwear for 3-4 days until the dressing has been changed. As you have had a local anaesthetic you should go home and rest for the remainder of the day following your surgery.

How long will it take me to heal afterwards?

This will depend on your general health and how well you follow the advice for looking after your toe post operatively. On average, 4-10 weeks. Pressure from footwear, infection and trauma to the area will delay healing. Contact your GP surgery if you have any concerns regarding delayed healing.

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Podiatry (foot care)