Nail excision is a simple procedure that involves the removal of a broken or infected nail. The treatment aims at restoring the normal anatomy of the nail and the surrounding structures. The procedure is indicated for severe nail injuries and ingrown toenails (nail growing into the skin of the toe). Nail excision is performed under local anesthesia.
Ingrown toenails are treated by nail ablation. Infection or abscess is drained from the end of the toe and extra tissue growing around the nail is removed. Ingrown toenails can cause open wound and could develop tetanus, so a tetanus immunization is given. The ingrown toe nail is cut along the edge and is pulled out. A small electrical charge or a liquid solution is applied to the exposed part of the nail bed to prevent the recurrence of the toe nail.
In case of injury, a tight band (tourniquet) is tied around the base of the finger/toe to decrease bleeding. Your doctor makes an incision in the skin at the side of the nail. A flat instrument is placed under the nail to separate it from its underlying skin. The damaged part of the nail is cut with scissors and removed along with any surrounding injured tissue. Your doctor may also remove the nail matrix (the region from which the nail grows) if necessary, using an electric current, chemical or laser beam. The incisions are closed and the wound is covered with a pressure bandage to prevent bleeding. Your doctor will prescribe medicines to prevent infection. Restoring the finger alignment may sometimes require splinting and using nail bed grafts to heal the damage and replace the injured portion of the nail.
Like all procedures, nail excision may involve complications such as pain, redness, swelling and infection.