Surgery for a nail bed inflammation

Treatment through an OP

Normally, an inflammation of the nail bed, which is also known as paronychia in medical jargon, is treated conservatively, i.e. with finger baths, antibiosis and immobilization of the corresponding finger.

If the nail bed inflammation is complicated, surgical measures may also be necessary to relieve the pressure. The pus focus is on punctum maximum (Place where something is strongest) opened under local anesthesia so that the pus (Pus) can drain. In mild cases, an incision is made in the cover fold. With the help of tweezers, the incision can be spread apart so that the pus can drain away. A bacteriological smear can be obtained from this so that the causative germ can be determined in a microbiological laboratory.

However, the pus is there below the nail, this must be partially removed, as this is the only way to ensure complete drainage of the pus. The Partial resection the affected nail is done with the help of a so-called Emmert plastic, at the one Wedge resection he follows. Under local anesthesia becomes a wedge-shaped piece of the toenail or fingernail including the adjacent ones Nail matrix (Nail fold, nail wall).

Is a ingrown nail (Unguis incarnatus) responsible for the nail bed inflammation, the surgeon can pass the nail through the Emmert plastic also zoom out. After adequate hemostasis, the wound becomes not sewn. She then heals under one without further precautions sterile bandage.

As part of the surgical procedure, if necessary, Tabs be placed in the wound so that the Drainage of the pus is still guaranteed. The tabs can usually be removed after a few days, provided that the Pus formation is for Standstill came. After completing the surgical procedure, a disinfecting ointment dressing created. In the following days is a daily dressing change indicated in the attending doctor's office, whichever one Finger baths With disinfecting solutions should include.

In addition, the affected finger should then use a Storage rail be immobilized. Also one antibiotic therapy is indicated because nail bed inflammation is mainly caused by bacteria how Staphylococci caused. After a few days, the result of the bacteriological smear so that antibiotic therapy can be adjusted if necessary.

It is of enormous importance that you are a layperson self the pus not opened or not tampered with it, because otherwise one would dangerous spread of germs can provoke. If there is no appropriate therapy for nail bed inflammation, the Infection continues to spread and the Destroy the nail bed or to a so-called Panaritium to lead. It is an infection of a finger with Melting down from tissue.

Indications for surgery

In most cases, inflammation of the nail bed can be treated conservatively with ointments or antiseptic baths. Antibiotics can be used if the nail bed inflammation is more advanced or if there is a fever and chills.

Read more on the topic: Treatment of inflammation of the nail bed

If the inflammation does not improve or even worsens, an operation should be performed. In addition, surgical therapy should be considered for purulent inflammation of the nail bed. If the cause of the nail bed inflammation is an ingrown nail, it can also be useful to remove it surgically. Before the operation, an X-ray is usually done to determine whether the bone is also affected by the inflammation.

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Duration of an operation

The duration of nail bed inflammation surgery can vary depending on the extent of the inflammation. Depending on where the inflammation is, a small incision on the side may be sufficient or part of the nail must also be removed. If tendons or bones are affected, the operation can take significantly longer. Usually, however, the operation is only a minor procedure and therefore only takes about a quarter to half an hour. As it is performed under local anesthesia and not under general anesthesia, the patient is immediately awake during the operation and at the end.

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Risks of an operation

The risks of nail bed inflammation surgery are low or rare. Nerves or blood vessels can be injured during the operation. If inflammation is very widespread, there is a possibility that the inflamed tissue cannot be completely removed and inflammation will recur after the procedure. In rare cases, an allergic reaction to the anesthetic can also occur. Usually, however, such an operation proceeds without complications.

Which anesthesia do I need?

The nail bed inflammation surgery is usually performed under local anesthesia. General anesthesia is not necessary for this procedure. Thus, the patient is awake during the operation but is not in pain. A sedative may be given prior to the procedure if desired.

How bad is the pain?

Inflammation of the nail bed can be very painful without treatment. Since the operation is carried out under local anesthesia, you shouldn't feel any pain during the procedure. Only the puncture of the anesthetic needle at the beginning of the operation can cause a small painful prick and a burning sensation. If the anesthesia wears off after the procedure, the area can hurt again. In this case, however, a pain reliever can be prescribed to alleviate the symptoms.

How is the healing going?

After an operation, the corresponding area must be immobilized, for example with the help of a plaster splint. Depending on the extent of the inflammation and the corresponding procedure, the hand or foot should not be stressed for one to several weeks until the wound has healed.

Read more on the topic: Inflammation of the nail bed on the toe

After very large interventions, healing can take months. It is therefore advisable to consult a doctor in good time to prevent the inflammation from worsening. In addition, wearing tight shoes after an operation should be avoided. If part of the nail was removed during the operation, it usually grows back on its own within three months.

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Follow-up treatment after an operation

After the nail bed inflammation operation, the area concerned is covered with a disinfecting ointment bandage. Depending on the extent of the intervention, healing can take a week to months. Usually, however, the area heals within several days. During this recovery period, the site should be immobilized. This can be supported with a plaster splint. After the procedure, the doctor can postpone pain medication to relieve any pain.