Partial Nail Avulsion Procedure (Ingrown Toenail Surgery)

A partial nail avulsion procedure with phenolisation is a surgical procedure to treat recurrent and painful ingrown toenails, especially when conservative care has failed. It involves removing the portion of the nail that is causing pain, followed by the application of phenol to prevent regrowth of the affected nail edge (chemical matrixectomy). This procedure performed under local anaesthesia, in a clinic setting, and is considered a safe and effective way to resolve painful and recurrent ingrown toenails.

Procedure:

1. Local anaesthesia: A local anaesthetic is injected into the base of the toe to completely numb the toe. A sensation test is performed to ensure that the toe is numb before proceeding to the next step.
2. Nail removal: The ingrown section of the nail is lifted and cut away, often extending to the nail root (matrix) where the nail grows from.
3. Phenol application: Phenol, a chemical agent, is applied to the nail root (matrix) to destroy the tissue and prevent future nail regrowth in that area. This is called chemical matrixectomy.
4. Wound care: The post-surgical wound and toe is then thoroughly cleansed and dressed with sterile dressings.

Recovery:

• Complete recovery typically takes 4-5 weeks.
• The toe may be sensitive especially in the first 48 hours.
• It is best to avoid covered footwear for the first 5 days post-procedure.
• Your podiatrist will advise on post-operative care instructions, such as keeping the area and dressings clean, intact and dry, so as to avoid an infection and provide optimal healing.

Benefits: 

• This is an extremely effective and safe procedure in resolving ingrown toenails and preventing recurrence.
• It is performed chair side by your podiatrist, with no need for hospitalisation.
• There is minimal scarring and downtime. You can walk and do light activity post-surgery.

Considerations: 

• While generally safe, potential complications like infection or delayed healing can occur. Your podiatrist will perform a thorough screening of your medical history and advise you on potential complications and how to avoid them.
• Phenol may not be suitable in some individuals. This will be advised by your podiatrist.
• Proper post-procedure wound care is crucial for successful healing.