(5) Inform the patient that he should expect exudate from the toe. The
exudate may last as long as three weeks.
Schedule a follow-up visit for one month later to assess the healing
a. General Considerations. A subungual hematoma is a collection of blood
outside the blood vessels (hematoma) in which the blood is located beneath the nail of
a toe or finger. This is a common type of fingertip crush injury. The patient may have
caught his finger in a door. This type of injury may be associated with soft tissue injury
and fracture of the fingertip. The most common complaint is pain. Treatment, if
needed, is drainage of the hematoma. Treatment does not require anesthesia and
usually produces relief from pain.
b. Treatment of Subungual Hematoma. Treat as follows:
Obtain x-rays of the fingertip to rule out fracture.
(2) Make a hole through the nail over the hematoma. To do this you may
use a paper clip heated with a match or a hot tip of a disposable cautery unit. You may
also make a window with a #11 scalpel blade.
(3) Drain the hematoma within the first few hours after the injury has
occurred. If drainage is delayed 24 hours or more, the attempt to drain the hematoma
will be useless because the hematoma will have solidified.
a. Common Warts (Verruca Vulgaris).
(1) Description. Warts of this type begin as smooth, flesh-colored papules.
They may evolve into dome-shaped, gray-brown hyperkeratotic growths. Although
these growths may be found on any skin surface, they most commonly occur on the
(2) Treatment: keratolytic therapy. Different techniques are used to treat
those warts. Keratolytic therapy and cryosurgery are two such techniques. See
paragraph 1-7b(2) for a description of this treatment.