Lateral edge resection and phenolization for ingrowing toenail

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After 4-point digital nerve block, a slice of 3–4 mm is cut from the lateral edge of the nail «Surgical interventions are more effective than non-surgical interventions in preventing the recurrence of an ingrowing toenail. The addition of phenol may increase the effect in preventing recurrence and regrowth of the ingrowing toenail.»A. The incision is extended through the root of the nail. Do not cut the cuticulum of the nail but displace it with the blunt tip of the scissors. Remove the nail edge and root by pulling with a forceps. In this patient the ingrown edge and root remain in place, and must be removed by an instrument. A suitable tool for applying 90% phenol is a metal pin with cotton wool tip. Two or three pins are dipped into the phenol and inserted into the cavity left by the root of the nail. Immediately after applying the phenol the wound and the surrounding skin is flushed with saline to prevent damage to the skin. The wound is left open. The patient is instructed to start bathing the toe on the next day. In this patient a torniquette around the proximal part of the toe to control bleeding was not used during the procedure - it is useful particularly if there is heavy bleeding.

Image 1. Lateral edge resection and phenolization for ingrowing toenail