Ingrown toenails can be caused by abnormal nail structure, aggravation and pressure from inefficiently fitted shoes, and most commonly, injudicious nail trimming where the sides of the nails are trimmed. As the nail begins to grow into the skin, the body begins to regard the nail as an unfamiliar object, resulting in distress and redness of the delicate tissue on the nail. If left untreated, the ingrown toenail can begin to cut into the skin, which can lead to contamination of the skin tissue with overflow or granuloma formation. A granuloma is tissue around an ingrown toenail that is red, moist, and enlarged.
If the ingrown toenail is towards the end of the big toe, a straightforward system called a fractional wedge resection can be performed, which has also reverted to the slope method. This is done by engaging the nail clipper at an angle to deal with cutting off the offending part of the nail. Legitimate follow-up and routine nail trimming after a half-wedge resection can prevent recurrence of an ingrown toenail.
All in all, basically removing the toenail wedge doesn’t completely solve the problem, especially on the off chance that the nail is seriously dug into the skin.
Surgical methods of treating ingrown nails are practiced in the workplace. Apart from the local anesthetic injection, there should be no agony during the technique. There are two major ways to remove a nail surgically. The first is the complete or incomplete evacuation of the nail. In this situation, the nail will return within the next 9 to a year. Most of the time, an ingrown toenail should not reoccur if the cause (such as improper nail trimming or tight shoes) is far away.
The subsequent strategy is incomplete or complete synthetic matrixectomy. With this strategy, part of the nail or the entire nail can be removed forever. The cuticle is the thin layer of tissue under the nail covering that forms the new nail; when this tissue is removed, the nail no longer develops.
In this methodology, the nail root, known as the grid and traced under the skin of the nail, is left alone. This will allow the nail to bounce back completely. This system requires a local injection to numb the big toe, a uniquely planned nail clipper to isolate the nail from the nail bed, and a small clip to remove the nail.
A local anesthetic is applied to the toe to numb the area around the nail. The injection is not performed in the area of the ingrown nail, but the infusion is applied to the base of the finger. Most patients describe the injection as a consuming and prolonged sensation.
When the thumb is sufficiently numb, the nail will bond to the soft tissue and cuticle of the nail. The piece of nail to be removed is then scooped out of the nail plate using a cutting edge and nail clipper. This is accompanied by the ejection of a nail with a small clasp. An antibacterial cream is applied to the area and the thumb is treated with wraps. The nail can take about 8 to 10 months to recover to its unique length.
Incomplete Composite Matricectomy/Complete Synthetic Matricectomy:
In this system, the nail root / skeleton of the nail is eliminated artificially using phenol or sodium hydroxide. Thanks to this, the nail recovers. A local sedative injection is performed using a similar strategy to the nail separation method above.
After the toe has been sufficiently numbed, a tourniquet is placed around the toe to prevent blood flow to the area. Preventing the bloodstream prevents weakening of the arrangement of phenol or sodium hydroxide and keeps the synthetics sufficiently able to satisfactorily smooth the nail root and grid.
When performing a “fractional” synthetic matrixectomy, an edge and nail clipper is used to remove a piece of the nail. The cutting edge and nail clipper are placed against the outermost edge of the nail and gently pushed down the nail plate against the skin of the nail. A cinch with a fine jaw is used to remove part of the ingrown nail. Up to this point in the method, everything is equivalent to the action of separating the nails. A Q-tip with phenol or sodium hydroxide is then inserted into the deep space and under the cuticle of the nail to kill the root of the nail. This system destroys the nail root on the ingrown toenail and allows the rest of the nail to develop as normal.
If an “all-out” synthetic matrixectomy is performed, the entire nail is removed and phenol or sodium hydroxide is applied to the entire area under the skin of the nail. In this situation, the entire nail does not recover.
Surgical warnings and complications:
It is possible that all or part of the ingrown toenail that was treated with a synthetic substance could come back. Since composite matricectomy is a substance that is consumed, this system will cause some exhaustion during the recovery system. This method allows for consumption that is not suitable for patients who have unlucky healing or unlucky blood circulation.
Management after surgery:
Between the hour of the surgical system and the following arrangement, Amerigel should be applied to the injury to promote the healing system. While this injury is healing, slight discharge from the area with mild redness and swelling is normal. Additionally, there may be some irritation that can be relieved with a pain reliever such as Tylenol. Usually, after surgical removal of the ingrown toenail, it is planned to subsequently ensure the requirement to perform legitimate wound care at the operative site and to screen the result of the ingrown toenail evacuation.