If recurring ingrown toenail is a problem for you, your podiatrist may recommend a procedure called a partial nail avulsion or PNA.
Most people wince at the thought of surgery for an ingrown toenail, because for many years treatment involved cutting into the groove at the side of the nail (the sulcus), scraping the nail bed and being stitched afterwards. However in the majority of cases this is no longer warranted.
These days, your family podiatrist may suggest a partial nail avulsion, where phenol is used to cauterise the nail. This is a less invasive treatment, using a local rather than a general anaesthetic which means:
- that PNA is a lot more affordable as it doesn’t require an anaesthesiologist;
- recovery is less painful and more rapid;
- and it can be performed at your local podiatry clinic.
Behind the Scenes at a Partial Nail Avulsion
Before the procedure: You will be carefully assessed to ensure suitability for PNA. For example, it is not usually recommended for diabetics, people with kidney or liver problems, or if you are taking blood thinners. Your podiatrist will explain the procedure to you, encourage you to ask questions, and provide you with pamphlets to read at home.
The room is well prepped and instruments are sterilised.
During the Procedure: Two podiatrists are required by law – one maintains a sterile field and performs the procedure; the other is non sterile (to reduce any chance of cross infection), and is there to monitor your comfort levels and step you through the process. The whole procedure usually takes less than an hour.
You will be given instructions on aftercare, and the nail should be dry and you should be feeling comfortable by the time you leave the clinic.
Because a local anaesthetic has been administered, we ask that a family member, relative or friend take you home. We also supply data about the amount of anaesthetic used, just in case you are involved in an incident (eg car accident) and need further anaesthetic in the next 24 hours.
Recovery and Aftercare
We recommend you keep the nail dry for two days, and keep your foot elevated. Usually paracetamol is all that is required for pain relief, as there has been no cutting or stitching.
A follow up consultation 2 days post procedure is part of the initial fee, and allows your podiatrist to check for infection or any other problems. At this appointment you will be given dressings, antiseptic and further instructions on follow up care. Of course if there are any problems, please call us immediately, at no extra charge.
As with any medical procedure there are potential risks, the main one being infection. There is a very slight chance of regrowth; for the small number of clients who do not respond well to phenolisation (ie the nail regrows), your podiatrist will refer you to the appropriate practitioner for an excision procedure .
It might sound scary, but a partial nail avulsion should cause minimal disruption to your life, and provide an effective permanent solution (1).
Call us today to discuss treatment options if you are having problems with an ingrown toenail – phone 3207 4736.
- https://ebm.bmj.com/content/5/1/26 – viewed 22.08.19