All nail surgery patients are initially seen for a 30 minute assessment appointment.
During the consultation we will take your medical history, in addition to the physical assessment. It helps us greatly if you complete a medical history form and bring it with you, copies can be downloaded here. We record details including your: name, address, telephone number, email address, date of birth, GP name and address, past and current medical history, allergies, medication, and any previous Podiatry treatment.
This is known as your minimum data set and recording it is a legal requirement. If you refuse to give us this information we will not be able to offer you treatment at our practice. We keep all the information you give us confidentially, in accordance with the guidelines laid down by the College of Podiatry, the Health & Care Professions Council, and the GDPR (we are data users registered with the Information Commission).
In most cases treatment will not be provided at your first appointment, and you will be invited back at a later date. If your toe is infected it may necessary for us to give you a course of antibiotics prior to any surgery.
NB we normally write to your GP, after your first appointment, to inform them that you are registered with our practice and give brief details of any treatment plan. Please tell us if you do not wish us to communicate any information to your GP.
The underlying problem
Sometimes toenails can curve in (known as involution) or ingrow (known as onychocryptosis) causing pain and discomfort. Involuted nails dig into the sulci (the grooves to the side of the nail), whilst ingrowing toenails normally puncture the skin at the side or apex of the toe. Ingrowing toenails can be excruciatingly painful, and are usually swollen, red, inflamed, exude pus and may impair your mobility.
medial involution
bilateral involution
non-infected ingrowing toenail
infected ingrowing toenail
What are the causes?
Involuted toenails can be inherited or may be caused by toes that stick up and rubbed by shoes, or by the long term use of slip-on footwear.
Ingrowing toenails are usually caused by poor toenail cutting or digging down the side of the toenails, they can also occur due to trauma and wearing tight footwear. There are two forms of ingrowing toenail – spicule (spike) and shoulder.
How do you fix this problem?
We anaesthetise the toe(s) using a local anaesthetic into the base of the toe. Once it has gone numb we apply antiseptics and a tourniquet
We then remove the ingrown (involuted) section of the nail and any scar tissue or hypergranulation tissue
A chemical called phenol is applied to cauterise the nail bed (matrix)
When cautery is complete the area is cleansed to remove excess chemicals and tissue debris
The toe is dressed ready for you to go home
