(c) Using scissors, completely split the nail in a longitudinal direction.
The split should include the base of the nail that rests against the cuticle.
(d) Using a straight hemostat, grasp the portion of the nail to be
(e) Remove the nail, using a steady pulling motion with a simultaneous
upward twist of the hand toward the affected side.
(f) In case of recurring problems with the regrowing toenail, it is
recommended that the germinal tissue of the toenail be removed permanently. To do
this follow this procedure:
1 Sponge the exposed nail bed dry with cotton swabs.
2 Cauterize the area by applying phenol to the nail bed tissue.
Avoid allowing phenol to come into contact with normal, healthy skin.
3 Hold a phenol-dampened swab in place for three minutes.
4 Swab the area with an isopropyl alcohol swab to neutralize the
Apply antibacterial or antibiotic ointment to the nail bed.
Cover the area with a sterile gauze pressure dressing.
Remove the tourniquet.
g. Follow up Care. Advise the patient to rest his foot during the first 24 hours
after surgery and to elevate his foot when possible. Tell him to return in 24 hours for a
dressing change. The procedure for the dressing change is as follows:
Re-apply antibacterial ointment.
Apply a less bulky dressing.
Encourage ambulation and a return to normal activity within the next two
(4) Tell the patient to soak his toe in warm water after the next 48 hours.
The soak should be in warm water for twenty minutes two times a day.