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Does anyone know whether post operative healing following PNA would be shorter without using phenol?

I have a patient who is desperately needing to train intensively for a promotion in the military and cannot afford to take too much time off training for healing.

Conservative treatment for his ingrown toenail is proving futile and nail surgery is the best option in my opinion. He understands the nail will grow back without phenolisation but would prefer that if it meant he could get back to training quicker and then undergo the procedure with phenolisation at a more convenient time.

Any thoughts on recovery time would be appreciated please!

 

Yes according to the literature (and common sense that phenol causes a caustic burn hence should take longer) it will take shorter without using phenol. The nail "may not" grow back without phenolization. Successful complete removal of the matrix could provide you with a permanent result alone. I do these routinely for the same reasons you stated above - works a charm. Good luck!

 

I agree. Without phenol, you can expect temporary resolution (in a fit and healthy person such as this) in the same time span as a cut. However, you could carry out a Frost or Winograd type procedure and expect healing within 10 days, which might be the best bet.

All the best

Bill Liggins

 

Many thanks to you both for your speedy replies and I now have one very relieved patient!

Kind Regards

Karen

 

I agree with what has been said so far, having done nail surgery over many years. Without phenol the wound can heal in a week or two weeks as with any other wound. However i would add that the nail will return and can quite possibly be thicker or even gryphotic due to nail bed trauma followed by hypertrophy. This has been my experience in a mining area where traumatic nail avulsion can occur. Indeed this was the case with my own father

 

Agreed. I often do this on patients who are about to go away or on athletes/dancers who are in competition to provide palliative relief and avoid a long wound healing period. It's all about matching the procedure to the patient's needs, really.

Hope that helps.


Tim

 

Depending on the nail shape....is it possible to take the offending nail out at an angle that only infringes on a small corner of the matrix?? Trying not to damage the matrix at all. In other words, taking out a large triangular shape, as opposed to a straight down , splitting the matrix shape??