If you have an infected toe and you are trying to manage it at home then you can pop into the clinic and purchase our dressing pack which has everything you need to keep the toe nice and clean and as sterile as possible.

What is nail surgery?

If you have a nail condition that cannot be resolved by routine nail care at the clinic, we may advise that you have either part of the nail removed (a partial nail avulsion) or the whole of the nail removed (a total nail avulsion).

The injection stings a bit but it is over quite quickly. After that you won’t feel any pain, although you will still feel us moving your toe about.

Removal of the piece of nail will relieve the pain and eliminate the cause of infections. Sometimes nails are very thick and cause pain or discomfort from shoe pressure. In this case the whole of the nail needs to be removed.

We then apply a chemical to the nail bed to stop the nail growing back.

Why do people have nail surgery?

The most common reason for having nail surgery is an ingrowing toenail. Anyone who has experienced this condition will know just how painful it is and also how frequently it causes painful infections.

Will it hurt when the anaesthetic wears off?

The anaesthetic generally wears off after a couple of hours. You may feel some discomfort but this varies from person to person. If necessary, take a pain relief tablet. Do not take any medication that contains aspirin as it may cause bleeding. However, if you take aspirin as part of your normal medication you should continue to do so. Children under the age of 16 having the surgery must be accompanied by a person with legal parental responsibility. If you are not sure who has legal parental responsibility, please contact the clinic.

You will be at the clinic for around 90 minutes and are not allowed to drive so please arrange a lift for someone to collect you after surgery.

Surgery will be performed at the clinic in Southdown Harpenden normally by the Podiatrist who assessed you on your first appointment. All of our podiatrists are qualified to carry this procedure out.

We advise that you bring someone with you, even if they do not want to be in the clinic room with you while you are having the procedure. Small children are not allowed into the room.

We advise that you eat and drink normally on the day of your procedure but avoid alcohol for 24 hours before and after surgery.

If you take warfarin please bring your INR book with you. If your INR is not stable, phone the clinic for advice as soon as possible before your appointment. If you have asthma and/or angina, please bring your medications with you. ALSO THE DRESSING WILL BE BIG so you will need to bring some sandals or very roomy open-toed shoes. Nails should be free of nail varnish.

Do you need to know if there are any changes to my health?

Yes, it is important you let us know if there are any changes to your health or medication. There is a limit to how much local anaesthetic you can have in a 24 hour period. Avoid any procedures which may involve a local anaesthetic, for example at the dentist, 24 hours before and after your appointment with us.

Are there any risks?

No surgery is without risk. It is possible that:

• The nail will regrow
• The wound may get infected
• It may take longer than average to heal
• You may experience an allergic reaction to the local anaesthetic or the phenol
• There may be some scarring
• The local anaesthetic may take longer than usual to wear off. It is very rare that it won’t wear off at all and your toe will be permanently numb.
• If we remove both sides of the nail you may temporarily lose the remaining nail.

The chemicals we use may cause harm to an unborn child. So if you are pregnant, or think you might be pregnant, we will not be able to carry out this procedure. We would also advise against anyone pregnant accompanying you into the treatment room because of the possible risk from the chemical fumes.

Will I be able to walk afterwards?

Yes, although you must be careful because your toe will be numb. We advise you to rest with your foot up in the waiting room for about 10 minutes before you go and then sit with your foot up again when you get home, however, you should try to walk periodically.

What do I do if my toe is infected?

If your toe is infected on the day of surgery it may mean we are unable to carry out the procedure. If your toe is very hot, red, swollen or there is pus please make an appointment with your GP to see if antibiotics need to be prescribed. You will need to do this at least four days before the date of surgery to give the antibiotics time to work. If you are not sure what to do, please contact us.

You should not drive until the effects of the anaesthetic have worn off (as advised by the DVLA). Do not use public transport or walk home after your surgery. Please make alternative arrangements.

When can I wear normal shoes?

We will replace the dressing after one or two days. The new dressing will be much smaller and will allow you to wear ordinary shoes. Your toe will heal more quickly if there is nothing pressing on, or squashing, the wound area, so either roomy shoes or open toes sandles or socks are best.

How long will I be off work?

That depends on the work that you do. We recommend that you do not return to work immediately after the surgery, and it may be advisable to stay off work until after your first redressing.

How long does it take to heal?

Everyone is different but on average it takes four to six weeks to heal if part of the nail is removed and 10 to 12 weeks if the whole nail is removed. During this time you will be able to walk and carry on your life as normal although you should avoid sporting activities or dancing.

Will I need to change the dressings myself?

You must leave the first dressing on until your first redressing appointment. After we have redressed your toe we will give you some dressings and advise you how to look after your toe yourself. We will also see you for a further 6 weeks minimum to ensure the toe is healing.

How to change your dressing (after your first redressing appointment)

• Wash your hands before you begin.
• Boil some water and pour it into a clean bowl and throw the water away- then pour in more boiling water and cold water so the water is tepid in temperature; Add a couple of hand fulls of salt.
• Clean the wound area with the salt water.
• Check for signs of infection (see below).
• Dry around the wound with a clean paper towel.
• Allow the wound to dry naturally.
• The toe should be dry before you apply a fresh clean dressing.
• Repeat daily. (unless advises differently).

While your toe is healing it will be weeping and/or discharging. This is healthy and normal and does not mean your toe is infected. Check the toe when you are redressing it for signs of post-operative infection.

This includes:

• Pain.
• Redness.
• Heat.
• Swelling.
• Smelly and/or excessive discharge.

A combination of the above rather than one only may mean you have a post-operative infection. If you suspect that you may have an infection then we would recommend you see your GP, out-of-hours GP service or visit a minor injury unit (MIU). If you have any other concerns please contact us. If you are prescribed antibiotics while under our care please let us know.

If you get to a point where you are struggling to manage this then please give us a call on 01582 766614 and we can book you an appointment or alternatively click the link below to take you to our Booking Form.