Why would I want to have Ingrown Toenail surgery?
Ingrown nails are often infected, bleeding and painful. Although many ingrown toenails can be fixed quite conservatively by a podiatrist, sometimes a more long term solution is required. If an ingrown toenail is the result of a one off thing, for example a nail cutting accident, then one visit to trim out the sharp edge may be all that is required. In contrast, if the underlying cause of the infected ingrown nail is a deformed toenail that cannot be tamed, a permanent solution such as ingrown toenail surgery is needed.
What are the types of Ingrown Toe Nail Surgery?
Ingrown toenail surgery is known in podiatry as a nail wedge resection. At Walk Without Pain Podiatry Clinics Brisbane, we almost always use chemical to kill a portion of the nail growing cells. This is called chemical cautery and it doesn’t involve cutting the skin or having any stitches. The only wound from the process is a chemical burn about the size of a match head. The surgery results in a slightly narrowed nail which no longer presses on the edge of the toe causing pain.
The alternative to chemical cautery is a ‘sharp’ procedure such as a Winograd Procedure. This involves cutting the flesh at the base of the nail, curetting or cutting out the nail growing matrix and stitching the wound closed. More information about this can be found on Youtube, searching for the term Winograd. It is very rarely employed in our clinic.
How is Chemical Ingrown Toenail Surgery performed ?
In the chemical surgery, the podiatrist begins by using a local anaesthetic to numb the toe. The injection is applied to the base of the toe that the surgery is to be performed on. This is well away from the painful area. Once the toe is numb, a tourniquet is applied. The podiatrist then uses a very, very fine chisel-like tool, actually designed for use in neurosurgery, to cut through the nail length ways. This is just the nail and not the skin. The section of the nail that has been cut away is then removed. This removal leaves a small pocket under the fold of skin at the base of the nail. A chemical is then applied to this area which kills the nail growing cells. The area is then dressed with antiseptic. It is not usual to need antibiotics for this procedure. This process requires no stitches and is permanent.
What will my toe look like after Chemical Cautery style Ingrown Toenail Surgery?
It will look roughly like this. Note the great toe is narrower on both sides of its nail. The other tell tale sign is the very straight nail edges. The nail does look a bit different if examined closely. Happily, a much better look than the infected and bloody toe that lead you to seek treatment.
What is the cost of Ingrown Toenail surgery?
A single nail wedge resection will cost $340 and covers the procedure as well as the local anaesthetic that will be used to numb the area. If you are having two toenails done at the same time it will cost $550. As we are podiatrists, the treatment attracts a health fund rebate depending on your level of cover. You can check your rebate by calling your insurer and quoting the item number F 546. If they do not recognise this code, try F014 or F440.
What aftercare is required for a Nail Wedge Resection or Ingrown Toenail Surgery?
Although there is not usually much pain associated with a nail wedge resection your podiatrist might recommend Panadol for the night of the procedure. There may be a low level throbbing pain that might wake you. It is recommended that you keep reasonably quiet for the following 12 hours or so. Generally speaking though, it is usually much less painful to have this job done than it is to have an ingrown toenail in the first instance.
Following ingrown toenail surgery, the podiatrist will dress the original wound and it is important to keep the dressing dry to avoid infection. Although tricky, it is recommended that the foot be wrapped in either glad wrap or a plastic bag when showering. You should return to the podiatrist after three days to have the pocket of the wound cleared. This allows the weeping from the chemical burn to escape the area. This does not require anaesthetic and it is not a painful process. During this consult the podiatrist will teach you how to properly care for the healing wound at home.
If you wish to visit us to discuss treatment options, please use our contact page here to contact us by telephone or email, or use our 24 hour booking portal.