what are ingrown toenails?
Ingrown toenails are a very common condition. The corner or side of your toenail grows into the soft flesh. You’ll know that you possibly have an ingrown if you notice redness, swelling and, sometimes, an infection in the affected toe.
WHAT CAUSES IT?
Ingrown toenails can be caused by wearing shoes that are too tight, cutting your toenails too low, or from an injury. Sometimes, your toenails just naturally curve in a way that makes it more likely to be ingrown. Usually, you can correct the issue with proper nail care. But if it persists, you may need to have surgery.
WHEN DO I NEED SURGERY?
Surgery is required when an Ingrown toenail repeatedly gets infected, is continually painful to the point where you may not be able to wear shoes. Removal of Ingrown toenails is the most common surgical procedure done at our clinic and is called a Partial Nail Avulsion.
Partial Nail Avulsion (PNA) is a minor surgical procedure that removes a piece of nail from the edge of an ingrown toenail to relieve the pressure and pain. During the procedure, a chemical agent is applied to the root of the nail area to prevent regrowth of the nail.
Before we begin the procedure, we will conduct a complete assessment, taking note of your medical history, a list of medications and medical conditions, and conduct an examination of blood supply to the foot. Once assessed, we will schedule you for surgery, which will take about 45-60 minutes. The procedure is done in our clinic with local anesthetic injected into the affected toe(s).
Nail Surgery Procedure guide: understanding can help ease anxiety and set realistic expectations.
Step 1: Assessment and Consent
Your Chiropodist will assess your toe(s), explain exactly what will happen during the procedure, and make sure all your questions are answered. Written consent is always obtained before treatment begins.
Step 2: Local Anesthetic
Two small injections are given at the base of the toe, where it connects to the foot. These gently numb the toe so you won’t feel any pain during the procedure. The numbing takes effect quickly, and you’ll remain awake, relaxed, and comfortable the entire time. This ensures the procedure is completely pain-free.
Step 3: Surgical Procedure
The toe is first cleaned with an antiseptic solution. Once the toe is fully numb, the procedure begins. A small tourniquet is placed around the toe to temporarily reduce blood flow, allowing the Chiropodist to clearly see and safely perform the procedure.
For a Partial Nail Avulsion, the Chiropodist carefully cuts along the ingrown edge of the nail and removes the problematic section. A special file is then used to ensure any remaining nail debris or sharp edges are smoothed and cleared from the area.
For a Total Nail Avulsion, the Chiropodist carefully removes the entire nail and checks the nail bed to ensure no remaining nail fragments are left behind.
Step 4: Nail Matrix Treatment - Preventing Regrowth
A small amount of Sodium Hydroxide, a medical chemical solution, is carefully applied to the nail matrix (the area where the nail grows from). This helps sterilize the area and prevents the problematic part of the nail from growing back. The solution may be applied several times to ensure the treatment is effective.
Once this step is complete, the tourniquet is removed, and normal blood flow to the toe resumes.
Step 5: Dressing the Toe
The toe is carefully cleaned and dressed with a sterile bandage. Throughout the entire procedure, you will not feel any pain because the toe has been fully numbed with local anesthesia. The procedure is performed using sterilized instruments and precise surgical techniques to minimize tissue trauma and support faster healing.
Step 6: Aftercare Instructions
Your Chiropodist will provide detailed aftercare instructions and guidance to help your toe heal properly and minimize the risk of infection after the procedure.
What to Expect After Nail Surgery
Immediately After the Procedure
Your toe will be covered with a sterile dressing to protect the area. Because the toe was numbed with local anesthesia, it may remain numb for a few hours after the procedure. Once the numbness wears off, you may experience mild discomfort, which can usually be managed with over-the-counter pain relief if needed.
Healing and Recovery
It is normal for the toe to have some drainage for the first few days as it heals. Keeping the area clean and following your aftercare instructions will help reduce the risk of infection and promote proper healing. Most patients are able to resume normal daily activities within a short period of time, although strenuous activities should be avoided until the toe has healed.
Dressing Care
You will be given clear instructions on how to change the dressing and care for the toe at home. This may include soaking the toe, applying fresh bandaging, and keeping the area clean and protected.
Follow-Up Care
In some cases, a follow-up appointment may be recommended so your Chiropodist can monitor healing and ensure the toe is recovering properly.
When to Contact the Clinic
You should contact the clinic if you experience increasing pain, significant redness, swelling, or signs of infection.
ARE THERE RISKS?
As it is a surgical procedure, there is some risk of complications, however this procedure is known to be very safe and effective. There are possible risks of infection, or regrowth of nail. The risk of infection can be minimized through good post operative care, which we will advise you on after the procedure is done.
IS SURGERY COVERED BY OHIP?
Procedures done in our clinic are not covered under OHIP. However, if you have private insurance through your employer or school, check to see if the surgery will be covered.
We can book you for an initial assessment and provide you with an estimate to give to the insurance company.