Types of Surgeries

Matrixectomy - Ingrown Toenail Surgery

Overview

What is an ingrown toenail? This common condition occurs when the corner or side of a toenail slowly grows into the soft fleshy bits of your toe. This may cause pain, swelling, redness, and in rare occasions, infection. The big toenail is the most common digit affected.

Those who have diabetes or other conditions that cause blood to pool in the feet may be at greater risk of complications of ingrown toenails. If you have such a condition, you will need to tell your doctor before undergoing surgery.

Why?

Ingrown toenails can usually be taken care of without the help of medical intervention. However, if the condition becomes too painful, swollen, or infected, a minor surgical procedure to remove the toenail may be required.

Left untreated or undetected, an infected ingrown toenail can lead to a serious bone infection or even gangrene (the decay and death of tissue). This is why it is important to see your doctor if you are experiencing severe discomfort in your toe, or if you see pus or redness spreading around the toenail.

All surgeries, whether they be big or small, carry risks. For an ingrown toenail removal surgery, these typically include:

Risks

Risks of Surgery

  • Infection of the surgical site.
  • Development of keloids (a thickened scar).
  • Excessive bleeding.
  • Pain, swelling, itchiness or tenderness at the site of incision.
  • Loss of sensation surrounding the surgical area if nerve endings need to be cut. This may be temporary or permanent depending on the damage.

What to expect prior to your surgery

You may need to take antibiotics before surgery. Routine blood work is usually not needed but may be ordered prior to surgery based on the patient's age and the presence of any existing medical problems.

Ingrown toenail removal is a minor kind of surgery, and is done on an outpatient basis (you will be able to go home after the surgery is completed). Before your surgery, a nurse or doctor will plan the site, clean the affected area, and consult with you for any questions you may have. Then, they will numb the toe using a local anesthetic so that you won’t feel any discomfort during the procedure.

The procedure itself can last anywhere between a few minutes to an hour depending on how complex the removal is. Typically, your doctor will give you a heads up on how long the procedure should last.

The procedure

The most common surgeries for ingrown toenails include:

  • Wedge resection: In this procedure, the doctor will remove a portion of the nail rather than the entire nail. Typically, it will only be the portion of the nail that is growing into the flesh.

  • Toenail removal: For this procedure, the doctor will remove the entire nail. This is reserved for extreme cases as removing the entire nail may lead to the nail regrowing in atypical ways.

  • Surgery on the tip of the toe: If removing the nail or portions of the nail is not an option, removing or reshaping the end of the toe may be required.

  • Matrixectomy: If wedge resection or nail removal fails, removing the nail bed entirely may be preferred. This will cause the nail to never grow back.

Your surgeon may also cut deep into the toe or nail bed to relieve swelling or drain infected tissue.

After the procedure

Recovery time for an ingrown toenail removal will vary, but you should feel back to normal within a few days to weeks depending on whether or not you received stitches. Be sure to keep the area clean and dry to avoid the possibility of infection. Itchiness or soreness is common, however let your doctor know if you experience swelling or excessive pain.

You will need to arrange for a ride home the day of your surgery and we recommend someone stay with you for the first 24 hours at home. When you leave the facility after surgery, we will want you to go home and rest. Avoid making any other plans on the day of your surgery. Starting the following day, you can increase your activity as you feel up to it.

You will likely be given a prescription for pain medication following your surgery. The recovery nurse will discuss a pain control plan following surgery specific to you and your needs including activities like ice applied over incisions and a medication regimen. Oftentimes we will recommend taking Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve in addition to the narcotic pain medication.

Lastly, know that there is a high likelihood you will be left with some kind of scar.

Did you know we have a support group?

Your questions and concerns have most likely been asked and answered in our support group. Moderated by our dietitian's, nurses, and staff. We provide you with reliable patient education and resources to help you throughout this life-changing process.