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Patient information: See related handout on ingrown toenails, written by the authors of this article. Obtain surgical consent after explaining to the patient the risks, benefits, and alternatives.
Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser. Minimizing postoperative drainage with 20% ferric chloride after chemical matricectomy with phenol. Randomized clinical trial of surgical technique and local antibiotics for ingrowing toenail.
7 effective remedies ingrown toenails - treat, Afterward, the inflamed area may start to drain yellowish fluid.
10 ways treat ingrown toenails everyday health, Ingrown toenails painful, tricky treat easily infected recurring problem. The list below contains links to several sources of information about this topic, of varying length and complexity of detail.
Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.
People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self treatment and seek podiatric medical care as soon as possible. Other "do-it-yourself" treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided.
Wearing shoes that are too tight or too short also can lead to this painful condition, which is most common in big toes. To treat an infected ingrown toenail, soak your foot in warm, soapy water several times a day.
You can lower your risk of developing an ingrown toenail by trimming your nails straight across with no rounded corners. A nail that is curling (involuted or convoluted) into the flesh, but isn’t actually piercing the skin isn't an ingrowing toenail, but can feel very painful and also appear red and inflamed as well. Ingrown toenail home remedies, treatment symptoms, Ingrown toenails facts; ingrown toenail? Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. Because of poor visualization or instrumentation, a barb is created that anchors itself in the soft periungual tissues and penetrates deeply as the nail plate grows distally.

Mild cases are characterized by nail-fold swelling, erythema, edema, and pain with pressure.
Conservative therapy provides a cost-effective approach that obviates the need for a minor surgical procedure and its attendant short-term minor disability and pain. Place the patient in a supine or seated position with the affected toe (Figure 4) and foot hanging off the end of the table.Prepare the affected toe with standard povidone iodine solution. This new nail growth results in an inflammatory reaction, often necessitating another procedure. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
Ingrown toenails can happen if you cut into the corners of your toenails when you trim them.
They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure.
Gently lift the edge of the ingrown toenail and insert some cotton or waxed dental floss between the nail and your skin. The length of your toenail should extend past your skin, and the top of each nail should form a straight line across, level with the top of your toe. Moderate cases are associated with increased swelling, seropurulent drainage, infection, and ulceration of the nail fold. One conservative treatment option is to soak the affected toe and foot for 10 to 20 minutes in warm, soapy water.
Although the use of oral antibiotics before or after phenolization is widespread, their use is based solely upon historic practice without evidence from clinical trials. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization.
If the toe is healing poorly several weeks after the procedure, debridement, oral antibiotics, and radiographic evaluation may be warranted.12Patients should be instructed before the procedure that the appearance of the affected nail will be permanently altered and that the recess created by the removal of the nail and granulation tissue will gradually resolve to a somewhat normal appearance. If painful or infected, your podiatric physician may remove the ingrown portion of the nail; if the condition reoccurs frequently, your podiatrist may permanently remove the nail. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too.
Electrocautery, radiofrequency, and carbon dioxide laser ablation of the nail matrix are also options.

Toenails should be cut straight across, and the corners should not be rounded off.Risk factors predisposing to development of ingrown toenails include anatomic and behavioral mechanisms. Remove it by twisting the avulsed nail outward toward the lateral nail fold while pulling in a straight direction toward the end of the toe. If you are in a lot of pain or the infection returns, your doctor may remove part or all of the affected nail. Some experts suggest that wider nail folds and thinner, flatter nails increase the risk of ingrown toenails,3 but this remains unproven. A sculptured acrylic artificial nail can also be used in patients with an ingrown nail and no granulation tissue.
Ensure that the entire nail fragment and flat edge of the nail bed is retrieved to prevent formation of a nail spicule and the potential for recurrence of an ingrown nail.Release the tourniquet after adequate hemostasis is achieved. Partial nail avulsion followed by either phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toe-nails.
Advantages of these techniques include less bleeding, reduced postoperative pain, and immediate sterilization of infected tissue. Options for destruction of the nail-forming matrix beneath where the nail plate was removed include phenolization or mechanical destruction of the nail matrix.
Compared with surgical excision of the nail without phenolization, partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence of ingrowing toenails, but has a slightly increased risk of postoperative infection. Formable acrylic is then placed on the nail and platform and molded into a nail shape to cover either a portion or the entire nail area surface.
The carbon dioxide laser offers the advantage of limited thermal damage to adjacent tissues. For phenolization, apply an 80 to 88% phenol solution directly to the nail matrix three times for 30 seconds each round (Figure 8). In older persons, spicule formation can become a chronic problem caused by their reduced ability to care for their nails secondary to reduced mobility or impaired vision.
Apply phenol only to the matrix and not the nail bed or surrounding tissue, which may delay wound healing. Phenol should not be used if the patient, physician, or medical assistants may be pregnant.

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10.09.2014, author: admin

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