Ingrown Toe Nails Medical Treatment

Medical Care:

Treatment options depend on the stage of ingrown toenails, medically known as onychocryptosis

Stage 1 can be managed by recommending shoes with a comfortable wide toe box or open-toed shoes Instruct the patient’s parents to cut the nail straight across and avoid cutting back the lateral margins The nail edge should extend past the tissue

Stage 2 can be treated by stretching the soft tissue away from the side of the nail, elevating the offending edge of nail from the soft tissue, and placing a small pledget of cotton under the nail edge to lift it back into the nail grove Instruct patients with stage 2 ingrown nails on how to perform this treatment Parents should also be instructed to have the child rest, keep the foot elevated, and use warm soaks

Stage 3 should be treated by removing the nail margin as described in “Surgical Care” Chronic ingrown toenails may require matrix ablation

Surgical Care:

Stage 3 ingrown nails require avulsion of the lateral border of the nail plate with sharp excision of the hypertrophic granulation tissue If avulsion has been unsuccessful in the past, partial or total ablation of the nail plate chemically, surgically, or via laser may be indicated
Prepare the digit with Betadine or alcohol if the patient is iodine allergic Perform a digital block with 2% lidocaine without epinephrine
Lift the nail off of the nail matrix bluntly all the way back to approximately one eighth of an inch under the proximal nail fold
Insert a scissors blade and cut the nail back to the proximal nail fold
Remove the free portion of the nail

Protuberant granulation tissue can be removed sharply or treated with silver nitrate
Bleeding, if any, is controlled with pressure
Antibiotic ointment and clean dressing should be applied

Consultations:

Consult a podiatrist for routine follow-up care or for patients in whom primary avulsion therapy has been unsuccessful
Close follow-up care with an orthopedist is required if inflammatory osteophytic changes are observed or if evidence of osteomyelitis is present

Follow-up with a primary care physician is indicated for any type of immunosuppression, including diabetes mellitus

Diet: No dietary limitations are required

Activity: Rest, keep the extremity elevated, soak the affected nail in warm water, and maintain limited weight bearing until healing has taken place

Gregory Mburu is a medical professional and part time marketer He post his helpful information about ingrown toenail at

http://nail-fungus-cureblogspotcom/

Tags | antibiotic, border, excision, lateral, margins, matrix, portion, result, silver, tissue