Nail Surgery - Patient Information

What is nail surgery?

Nail surgery is a procedure carried out to remove part, or all of a nail. Problem nails that we commonly treat are, infected ingrowing toenails and curved or distorted/thick nails that are causing pain. Phenol is used to stop regrowth of the nail.

What are the benefits of having nail surgery?

Permanent removal of part or the entire nail often cures the problem, although there is a small risk of re-growth. This procedure is known as ‘Phenol Matricectomy’ and has a success rate of 95% or higher, in preventing re-growth of the nail.

What will happen when I have nail surgery?

  • You will be awake during the procedure, and it is recommended you do not watch, in case it makes you feel unwell.
  • A local anaesthetic is injected in the toe to stop you feeling pain. A tourniquet is then put onto the toe to reduce bleeding.
  • The piece of nail causing the problem is then removed, and phenol applied to stop the nail from growing back.
  • The tourniquet is taken off and a dressing is put on to cover the toe.
  • You will be given advice about how to look after your toe and a follow-up appointment, will be booked before you leave.

  • What does it feel like to have nail surgery?

    Once the toe has been anaesthetized (numbed), you will be able to move the toe but will not feel any pain. There is some discomfort when injecting the anaesthetic but this only lasts a couple of minutes. The local anaesthetic usually wears off in 2-4 hours.

    Will nail surgery affect work or school?

  • If you have an active job, you may need to take a few days off work to rest the affected toes.
  • We recommend that you wear open toe shoes until the first redressing appointment. Please be aware that these may not comply with work Health & Safety requirements.
  • We would recommend that school children do not go back to school until after the first appointment where the toe is dressed (3 to 5 days).

  • What are the risks of not having the procedure?

  • If the nail is causing bacterial infection, then the infection is likely to reoccur even with repeated courses of antibiotics.
  • If the nail is causing discomfort this may continue.

  • What are the possible complications/risks?

    In rare cases, the following may occur:

  • Infection of the wound
  • Bruising from the injection or tourniquet
  • Reaction to the local anaesthetic
  • Pain
  • Periositis - inflammation/infection of the covering of the bone
  • Re-growth of the nail which may have to be removed if it is causing discomfort
  • Persistent wound drainage
  • Persistent numbness
  • Long healing time of between 6-12 weeks
  • Cosmetic changes - when healed usually normal skin will cover the removed nail.
  • If the nail does re-grow, it may grow back deformed even though the pain may have gone.

  • Medication

  • If you are on any type of medication please bring your most recent prescription with you on the day of the surgery.
  • If you suffer from asthma/breathlessness, it is essential you bring along your inhalers.
  • If you suffer from epilepsy, please bring along any necessary medication.

  • What to wear

  • Wear an open toe sandal or similar shoe on the day of your procedure. This will allow room for the dressing and helps avoid pressure on the toe.
  • Loose comfortable clothing.
  • A skirt or trousers which can be rolled back to the knee.

  • Transport

  • We would advise you not to use public transport or walk home after the procedure, as this may cause bleeding. Please arrange for someone to take you home in a car or make alternative arrangements.
  • Important note: Driving when your toe is anaesthetized may invalidate your insurance and make you unfit to drive.

  • General information

  • Please remove all nail varnish from toenails before attending the clinic.
  • Please bring your consent form with you.
  • You may bring a relative / friend / carer with you for support, but this is not essential unless you are under 16 years old. Anybody attending with the patient will need to be aware that observation of injections can result in feeling faint or fainting, and we would politely request that the person does not attend if that is a possibility. Accompanying persons may be asked to leave if the procedure is inhibited by their presence.
  • The time you need to allow for the procedure will depend on what you are having done. Whilst the actual procedure only takes 20 minutes, please allow 1hour for your appointment.
  • If you and the podiatrist are happy, you can leave the building, when the procedure has finished.

  • After the procedure

  • If you feel any discomfort we advise you to take a mild painkiller which you would normally take for a headache (but not aspirin).
  • Resting with the foot up for a day will help to ease any discomfort, so please make arrangements so this is possible.

  • Discharge

  • Slight discharge from the wound may continue for up to six weeks. If you are concerned, please return for the wound to be examined and redressed.

  • Dressings

  • Keep the dressing clean and dry until your first appointment when you will have a new dressing. We will show you how to dress your toe at the first appointment after surgery.
  • We would advise you to keep your operated toe and dressing dry whilst having a bath or shower.

  • Before