Using the scissors, debride any necrotic tissue.
(3) Infection under the nail. For an infection that has spread under the nail,
you must remove the proximal nail in this manner:
(a) Use mosquito forceps to lever up and hold the nail.
(b) Cut the nail off in a straight line using the scissors.
Place gauze packing under the flap of the overhanging tissue and
(4) Culturing the infected material. To determine what caused the infection,
culture the infected material you have removed from under the nail.
(5) Antibiotics. Usually drainage is sufficient to clear up the infection.
Antibiotics may be considered, however.
f. Follow-up Care.
(1) Short term care. Tell the patient to elevate his hand for one to two days
to prevent throbbing from the dependent position. The patient should return in two to
three days for the packing to be removed. After the packing is removed, he should soak
the affected finger in warm water for 15 minutes, three or four times a day. After each
soaking, a dry, nonstick dressing should be applied.
(2) Long term care. The nail must be protected from being torn away from
the nail bed until it regrows from its base. This regrowth process may take several
months. After the healing process is complete, the nail and cuticle may be deformed.
a. General Considerations. The removal of a toenail is a simple and safe
procedure. This procedure requires a minimum of skill.
b. Indications for Toenail Removal. A toenail may need to be removed in any
of the following circumstances:
Ingrown nail (ohychoptosis).
Ringworm or fungus infection of the nail (onychomycosis).
Inflammation of the nail fold (chronic or recurrent paronychia).
Deformed, enlarged, curved nail (onychogryposis).