Treatment Guide - Post-op instructions for patients following nail surgery

The procedure you underwent today is called a permanent partial (one or more borders of the nail) or permanent total nail excision. This procedure will heal a bit differently than a simple cut or scrape, therefore we ask that you please read and follow these directions carefully.

During your procedure, an acid called phenol was applied to the nail base. Phenol is used to destroy the nail cells so that the portion of treated nail will not grow back. Another added benefit of phenol is that it acts as a topical anesthetic, often keeping the surgical site numb for 2 weeks. The application of phenol will cause an intentional chemical burn. As a result, the wound will drain a bit more than what you may be accustom to when compared to a cut or scrape.

Many patients will notice significant drainage for the first 3-5 days following their nail surgery. Your job is to promote this drainage. This is accomplished by keeping the surgical site wet. We suggest one of the two following methods;

METHOD #1 (ambulatory soak)
Remove your bandage 12-24 hours post nail surgery. Make a small jar of Epsom salt solution, 1 tsp/pint of clean tap water. Soak a cotton ball in the solution and loosely tape the cotton ball to the surgery site. This is an easy way to ‘soak’ the site while active at home. Wear the wet cotton ball for 30 minutes twice daily for ten days following surgery. Between soaks, cover the toe with a traditional 1" ‘stretchy’ Band-Aid.

METHOD #2 (sit’n soak)
Soak the foot in Epsom Salts made to be 50% strength as described on the box of Epsom Salts. Repeat twice daily. Cover with a ‘stretchy’ Band-Aid following each soak. Continue for 7-10 days or until you no longer see drainage in the Band-Aid.

 

INSTRUCTIONS FOR ALL PATIENTS

  1. Take it easy for at least 2 hours following your surgery. Prop your foot up above the level of your heart on the ride home. Too much activity following your nail surgery will result in a bleed through on the bandage. A little bleeding is expected, but if you experience excessive bleeding following your surgery, please contact our office.

  2. Remove your bandage no sooner than 12 hours after your surgery. In most cases, the morning after your surgery is best time to remove your bandage.

  3. Showers are fine starting the day after surgery, in fact we encourage you to shower and use a wash cloth to gently debride (remove) any material in the wound.

  4. Do not leave your Band-Aid off thinking that ‘letting the air get to it for a while’ will help. This will only enable the wound to scab over, thereby inhibiting and blocking necessary drainage. If normal drainage is inhibited, you will form a sterile abscess that will require additional care.

  5. Post-op follow-up visit are 1 week following your procedure.

  6. A 1” ‘stretchy’ Band-Aid is all that is needed to cover the toe. Plastic Sheer Strip Band-Aids tend to fall off of toes so try to use the ‘stretchy’ Band-Aids.

  7. We encourage you to call with any questions or problems following your procedure.