Nail surgery can sometimes be required where a nail has caused a wound in the skin surrounding the nail.
This damage to the skin can sometimes be due to the shape of the nail, how it has been cut (leaving sharp corners or spikes) and pressure from footwear either pressing down on the toe or squeezing the toes together. It may be due to a one-off incident but can be aggravated if the cause is not addressed. Ideally this can be prevented by ensuring you do not cut down the sides of nails, that the corners of nails are visible beyond the skin fold and that shoes have plenty of room and have a fastening so your foot cannot slide to the narrow toe area.
If you have problems with ingrowing nails it is best to file the nail so that you are not tempted to cut down the sides and possibly make things worse by leaving a sharp corner or spike of nail.
You can get more advice about basic footcare by reading this leaflet.
Ensuring your shoes have deep enough toe boxes so the top of the shoe is not pressing on your nail and that your shoes are not short so that your toe is pressed into the end of the shoe will also help prevent causing nail pain. Buying shoes with a fastening such as laces, or straps with Velcro or buckle fastenings will enable you to wear shoes with enough space without sliding around in the shoe. This will also help reduce trauma to the nail and toe.
You can get more advice about footwear by looking at this leaflet.
Once you have a wound you may want to follow some advice about basic woundcare by reading this leaflet. Often, if the preventative measures above are followed with care, the nail is able to grow out without causing further damage to the skin so that no further treatment is required.
If you have a wound, it is not healing and you have repeated infections although you have followed some of the advice here, you may wish to be referred for nail surgery. Once you have been referred to the Podiatry Service you will receive a letter which may either invite you for an assessment appointment so we can review the nail(s) and any medical conditions that were reported prior to a nail surgery appointment to remove the nail, or your letter may invite you to an assess and treat appointment where the nail may be removed at the same appointment following a discussion about the options. Please read the letters and advice leaflets to help you understand the arrangements.
A Local Anaesthetic is used for our nail surgery procedures to ensure they are pain-free. We do not use general anaesthetics. If you do not feel this is appropriate for you please discuss this with your referrer.
Treatment options are discussed at appointments and signed informed consent must be provided to undertake the procedure.
Please read these leaflets so you aware of the arrangements you need to make on the day and post-operatively (nail surgery advice about avulsions and nail surgery caring for your wound).