Laser nail bed plasty of ingrown nails

Ingrown nails usually occur on  the big toe, it is caused by an inflammatory reaction between the hard toenail and the surrounding soft tissue. Ingrown toenails most common cause is tight shoe wear, local injuries, improper pedicure habits that often lead to unilateral or bilateral lesions and ingrown toenails. The gradually developing granuloma is a painfully throbbing, reddish ”proud flesh” that bleeds and discharges recurrently,  and may get a secondary infection. The inflammation of the sides is often asynchronous but sometimes develops at the same time. The removal of both sides at the same time is recommended in these cases since so you can get through the inconveniences of surgical procedure with a simple anesthesia and follow up treatment. The progression of an ingrown toenail is often followed up by a fungal infection that also has to be treated to achieve permanent recovery.

Tasks before surgical removal of ingrown toenail

The laser surgery of ingrown nails is always preceded by medical consultation when the circulation of the limb must be checked to prevent possible complications.

You will get information about the anesthesia, the surgical removal of the ingrown nail itself, your tasks during the post surgical period and the possible complications at this consultation.

The intervention can be done right after the consultation or later at a stated time. You should soak your toe in chamomile tea before the surgical removal of the ingrown nail and choose comfortable footwear for the post surgical period and buy some painkillers.

Laser nail bed plasty

The edge or edges of the ingrown toenail is removed in local anesthesia then the granuloma or „proud flesh” is removed with laser. The removal of matrix cells (responsible for the production of nail) is the next step with laser to prevent nail growing in this thin line and therefore the development of ingrown toenail; the narrower nail will not irritate its surroundings afterwards.

Possible complications

Complications may occur following the removal of the ingrown nail despite the surgeon’s best effort and utmost care.

Possible early complications are: post surgical bleeding, inflammation, allergic reaction; all of them can be treated if detected in time. Please consult with your surgeon in case of any unusual symptoms following the removal of ingrown nail. The bandage should be removed from the wound following a prolonged soak in chamomile tea than the wound of the ingrown nail should be applied with Betadine solution. In case of an inflammatory complication the disinfecting-cleaning soak and the application of Betadine should be repeated daily. When the wounds dries and exudate accumulates in spite of the above mentioned treatments and you experience a throbbing pain and swelling please soak the wound even more thoroughly or make an appointment to consult with your surgeon.

Possible late complications are: reoccurrence of ingrown toenail when not all the matrix cells were removed. The incidence is about 4-5 % in our patient population. Naturally the removal of the ingrown toenail can be repeated in this case.

Post surgical tasks

The bandage should be soaked in chamomile tea and taken off on the day following the removal of ingrown nail. You should clean the wound with lukewarm shower, dry it and apply Betadine twice a day. The healing process of laser wounds differs from normal ones. The wound of the ingrown nail will exudate following the surgical removal and the exudate is yellow but not purulent. The reddish edge around the nail bed is the natural consequence of a laser treatment and not a complication. You can take off the bandage and leave the wound free from the 4-5. day at home where the infection can be avoided. The application of vulnerary powders is not recommended following the removal of ingrown nails. The complete healing process takes 3-5 weeks depending on the presurgical extension of inflammatory process, the possible comorbidities, like diabetes or vascular stenosis.

You should come for the post op consultations on time and follow the instructions to avoid complications and other inconveniences following the removal of ingrown nail.