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Hi
This is the first time I've posted on this site (I'm a UK Pod Student) Podiatry Arena seems like a extremely useful website that I will be visiting regularly! I was just after some general advice on how to determine a nail tuft. I'm finding I can waste valuable time as I'm too cautious to nip nails to their proper length in case I cut a nail tuft. Any tips would be great.:confused:

 

Footinthecity

If you have a solution of 3% hydrogen peroxide (10 vols) a few drops across the free edge and sulci will give off nacent oxygen in the presence of tissue fluid and temporarily hydrate the skin - the makes it easier to determine vascular areas. It is a pretty violent reaction which helps displace loose keratin cells (making it easier to remove onychophosis). Often you will get a fizzy white precipitation which is water with the extra molecule released. If stinging is reported (very rare) dilute the application by adding water.

Hydrogen perioxide was commonly used in podiatry to clean out small wounds up until a few years ago when it was found it could damage granulating tissue. Since then it seems to have disappeared but is very useful when cutting tricky nails.

An alternative is to use 0.9% saline solution to hydrate the free edge of the nail.

toeslayer

 

we were taught in uni to squeeze the nippers and if the patient jumps there is a nail tuft! not sure if that is the best way though lol
most patients dont have nail tufts, and usually they are fairly obvious to you as flesh that sticks to the underside of the nail.
if you tilt your chair so you can see the underside of the nail when you are cutting you can make sure that your nippers is immediately under the nail and you are not grabbing any flesh, even with nail tufts you can still cut the nail short with this technique. if you nibble along the nail rather than opening up your nipper each clip your nipper tip will alos push the flesh aside as you cut rather than cutting through it.
its one of those things that will come to you with practice - and you will draw blood now and again - most of the time the patient is ok with it lol.

 

I trim the nail a bit, then use a wet drill where i suspect a vascular tuft. Works brilliantly, and can even cure the tuft!

 

Is the purpose of the wet drill to prevent it feeling hot on the patient?
thanks

 

Yes, having an accompanying jet of water keeps the bur cool, thus you can use it on skin.

 

I've never heard the term "nail tuft" before.


Is it a regional term?

 

Lecturers/ Uni Clinicians and NHS Placement Mentors have used this term with me in describing when skin gets pulled up towards the nail making it at times difficult to determine what is nail and what is skin when trimming nails. Not sure if its just a NW UK term though, I'm only a student at the moment!

 

netizens

dermal protrusion which is frequently very vascular

toeslayer