What is Surgery –Ingrown Toenail Surgery
DEFINITION When a toenail's lateral edge develops into the soft tissue of the nail fold, it causes inflammation and infection. Onychocryptosis is the medical word for this condition. AETIOLOGY Along its edge, the toenail grows into and enters the skin. It can cause a foreign body reaction, with a bacterial or fungal infection on top of it. Exuberant granulation tissue production can occur as a result of tissue healing. RISK FACTORS/ASSOCIATIONS Footwear that isn't well-fitting (particularly those with a tapering front), toenails that aren't well-trimmed, toe damage, and poor cleanliness. EPIDEMIOLOGY Common. Young adults and teenagers are more susceptible. HISTORY Pain along the toenail's borders, as well as a painful swelling toe. Make a diabetes inquiry. EXAMINATION Erythema, oedema, warmth, and soreness on the big toe are the most typical symptoms. The lateral side of the toenail is more likely than the medial side to be affected. INVESTIGATIONS In most cases, none is required. Swab of the pus: Culture and sensitivity, if infected Radiograph (toe): For osteomyelitis in diabetics and those with a serious infection. MANAGEMENT Medical: Simple pain analgesia and podiatrist therapy. If the foot is presenting early, it should be cleansed on a regular basis and dried carefully. Wearing clean socks and wide-fitting shoes is recommended, as is cutting toenails transversely. If infected (after incision and drainage if pus is found), antibiotics may be required, especially in diabetics. SURGERY Surgery is reserved for instances that are severe or recurrent. Local anaesthetic with a ring block. If there is a localised pus collection, an incision and drainage procedure should be performed. Avulsion of the toenail: The toenail is removed without causing damage to the nail bed. There's a 50% possibility of it happening again. Wedge resection: Using phenol to damage the nail bed, the lateral part of the nail that is ingrowing together with the nail bed is excised. This relieves pressure on the toe's sides and prevents the nail from growing back into the skin. Zadik's technique is as follows: This procedure entails the removal of the entire nail as well as the destruction of the complete nail bed. COMPLICATIONS Secondary fungal infection of the nail and toe, malformation of the nail bed and surrounding toe, and permanent nail loss. PROGNOSIS If caught early, the prognosis is often favourable. Recurrence can occur in up to 30% of cases. Diabetics have a greater morbidity rate, which can lead to toe amputation (or even limb).
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