In-grown nail and nail bed plasty

The most common reason of nail bed plasty surgeries is the disease occurring on the big toes, the inflammatory reaction of the connection between the hard nail and the soft part surrounding it.


In-grown nail, and the reasons behind it

Common reasons that lead to the development of one- or often two-sided mutations, in-grown nails, include wearing tight shoes, local injuries, and incorrect pedicure habits. The gradually developing inflammatory granulation tissue consists of painfully throbbing, reddish proud flesh that is prone to bleeding. This periodically excretes, then it might get superinfected. The inflammation of the two sides often happens at different periods, it is rare that they are at the same phase. In such instances, it is recommended to remove the in-grown nail at the same time from both sides, thus the discomforts that go with the procedure can be done away with in one local anesthesia and one post-treatment. The process of in-grown nails is often accompanied by fungal infection, the treatment of which is also an important task in terms of  long-lasting healing.


Things to do before nail bed plasty

The removal of in-grown nails - nail-bed plasty - is always preceded by a medical examination, during which we always need to explore the blood-flow of the limb, in order to avoid possible complications.
During the consultation, we inform the patient about local anesthesia, the removal of the in-grown nail itself, the things to do after the treatment, and possible complications.
Following the examination and consultation, the treatment can be done instantly, or during a newly chosen other appointment. Before the removal of the in-grown nail, it is recommended to choose comfortable shoes for the post-operation period, and to get a painkiller medication.


Laser treatment of in-grown nail

During the procedure, following local anesthesia, we remove the edge(s) of the in-grown nail, then we remove the inflamed granulation tissues, the proud flesh, with laser. After this, we remove - also with laser - the matrix cells responsible for producing nails, so that in this narrow lane, nails would not grow any more. By this method, the recurrence of the in-grown nail can be avoided, because afterwards, the narrower nail will not irritate its environment.


Surgical removal of in-grown nail

Following local anesthesia, we remove the in-grown nail-strip (simultaneous removal of a 2-3 mm wide strip of the nail, a segment of the nail matrix and the scar tissue that is bent onto it). After that, we destroy the substance from which the nail has grown out of, with chemical matricectomy (usually using phenol), which means putting strips of gauze imbued with chemicals into the open wound that formed in the place of the excised part of the nail, for about 2 minutes. After the procedure, we treat the wound open because of the current infection (we do not sew it together), we put a thick covering bandage on the toe. Following the healing of the wound, nail will not ever grow in the treated strip.


Possible complications

Following the removal of the in-grown nail, even despite the most precise and thorough medical intervention performed according to the rules of the profession, complications might arise.
Possible early complications following the removal of in-grown nail: after bleeding, inflammation, allergy, which are all easily treatable if noticed in time. Please contact your operating doctor as soon as you notice any unusual signs after the procedure. Remove the bandage on the day after the surgery (Usually, this is not difficult, as we put it on so it would not stick to the wound. If that happens anyway, do not tear it away, but remove it with soaking.), then apply Curiosa gel to the wound. To prevent an inflammatory complication, repeat this every day after taking a shower. If the wound dries up despite the treatments, and the excretion stagnates, causing throbbing pain and swelling, please soak the wound more thoroughly, or book an appointment for a follow-up examination.
A late complication can be the recurrence of the in-grown nail, if not all the cells that produce nails were removed. According to our own material, this happens in 4-5% of cases. If this happens, the removal of the in-grown nail is repeatable.


Things to do after the removal of in-grown nail

On the day following the procedure, the bandage should be soaked off with chamomile. Twice a day, it needs to be showered with lukewarm water, toweled dry, then Betadine needs to be applied.
The healing process of laser wounds differs from traditional wound healing. The wound at the place of the in-grown nail excretes after the procedure, which excretion is yellowish, but not purulent. The reddish edge of the nail is also a normal side-effect of laser wounds, and not a complication.
After the 4th or 5th day, if the contamination of the wound is avoidable, you can leave it without bandage at home. The use of vulnerary powder is not recommended after in-grown nail treatments. The complete healing process takes 3-5 weeks following the removal, which depends on the extent of the inflammatory process before the treatment, and possible accompanying diseases, such as diabetes and blood vessel narrowing.
After the removal of the nail, it is recommended to attend the follow-up examinations, and follow the recommendations to avoid complications and other discomforts.

Book an appointment via phone or online for laser or surgical treatment of in-grown nails!


         

      before treatment                         after treatment

Make an appointment with:
Gábor Egri MD
Gábor Egri MD
Tamás Barta MD
Tamás Barta MD
László Képíró MD
László Képíró MD