Ingrown toenail surgery

Wedge resection of nail and phenolisation
Summary

This operation is performed for symptoms caused by an ingrown toenail.  This usually affects the big toe when the nail curls in and pierces the skin.  This can lead to pain, redness and infections.   

Factors to Consider

You have been diagnosed with an ingrown toenail.  It is likely that you have already tried non-surgical treatments for your toenail such as trimming your toenails straight, regular bathing and footwear modification.  

If these measures have not improved your symptoms then the next logical step is to consider surgery.  

Description of Surgery

The procedure is performed as a daycase procedure under local anaesthetic.  The affected side of the toenail is removed to mkake the nail narrower. A chemical called phenol is then used to destroy the nail forming tissue at the base of the nail on that side. Occasionally the whole toenail is removed, particularly for more severe or recurrent cases.  

Anaesthetic

The operation is usually performed under a local anaesthetic.  The local anaesthetic will usually last for about 6 hours but you may experience pain once this wears off.

What are the risks?

All operations involve an element of risk.  The risks for this particular operation are small but it is important that you are aware of them.

The main risk is recurrence of the ingrown toenail.  This can be minimised by increased attentiveness when cutting your toenails after surgery.  The risk of infection is small and is thought to be less than 1%.  Most infections will settle simply with antibiotics.  

After Surgery

Pain

Local anaesthetic will be used during the operation and so you will feel comfortable when you first wake up.  This can last up to 12 hours but the foot may be sore after it wears off.  You will be given a combination of pain killers to go home with.  

Dressings

You will wake up with your foot in a bandage and a rigid soled shoe to allow for healing.  You will be able to walk on your foot but it will take a number of weeks before you can wear your normal footwear again.  

Driving

You can drive when you feel you are safe to drive.  This means that you feel confident that you have full control of your car and are able perform an emergency stop.  This will vary between patients but normally takes about a week.  

Return to work

This depends on what your job is.  You should be able to return to a “desk job” straight away.  If you have a more manual job it can take up to 6 weeks before you feel ready to return to work.  Please discuss this further with your surgeon or physiotherapist if you feel unsure.  A sick note can be given to you at the time of your surgery if required.  Please ask the nurses on the ward if you need one.

What to expect

Recovery following surgery can be quite variable but the expectation is that you will make a full recovery within the first 3 months.