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Ingrown Toenails (cont.)

Is Surgery Necessary for Ingrown Toenails?

If an infection is present, then surgical removal of either part of the nail or the whole nail and drainage of the abscess will be needed. This is performed in the doctor's office or in the emergency department. The extent of the procedure will depend on the severity of the infection, any other medical problems, and if this is a recurring problem.

How ingrown toenails are surgically removed

  • Sometimes a preoperative X-ray will be taken to make sure that the infection hasn't spread to the bone (osteomyelitis).
  • The doctor will inject a local anesthetic medicine.
  • The doctor will then drain the infection from the end of the toe or remove the extra tissue that has grown around the end of the nail.
  • At this point, the doctor will remove a portion of the nail so that the skin or infection can heal without the nail pushing on it.
  • The doctor may decide to destroy a portion of the nail matrix, the living tissue that produces the nail, by applying a chemical or by direct surgical destruction. This is performed so that the edge of the nail that caused the problem will not return, which is more likely with severe or recurring infections.
  • For very severe or recurrent cases that have already failed traditional surgery, a complete destruction of the nail matrix can be performed.
  • A lateral matricectomy is a procedure that surgically removes a portion of the nail bed and is usually performed by a specialist. It is considered the usual treatment for chronic or recurrent ingrown nails.
  • There are several newer types of surgery that don't alter the nail bed at all, instead they remove a portion of the soft tissue beside and/or underneath the nail in order to make more room for the nail to grow out. These types of surgery have shown promise but are not yet the standard of care, as they are still being studied. A flexible tube can also be slid along the side of the nail after removal of the extra tissue to help it heal properly.
  • Antibiotics are usually not prescribed for this problem because draining the abscess will take care of the infection.
  • The toe will then be covered with ointment and gauze.
Medically Reviewed by a Doctor on 3/22/2016

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Toenail, Ingrown »

Ingrown toenails (unguis incarnatus) are a common toenail problem of uncertain etiology.

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