Ingrown Toe-nails

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Hello There

I am a podiatrist and have recently opened my own practise in Germany.

We are not allowed to administer local anaesthetic like NHS qualified Podiatrists. This can make treating chronic ingrown toe-nails a bit tricky.

I would like some feedback on how other podiatrists treat a situation where they are presented with an infected nailbed and tissue-granulation (proud flesh) that exudes.

When a Ung. Inc. is too painfull to treat immediately I usually plug the area with and apply "Albothyl" to it and instruct the patient to leave it for 24 hours (no more). Then I give then some" Leukichtan " (wound healing ge -l Natriumbituminosulfonat 10 %) to apply on there for another 24 hours and to return to me. The proud flesh is then easily removed and one has a better view of what is hapening in the nail track.

Another option is is using Silver Nitrate 95% in pencil form on it an then treating it after 2-3 days. I have not tried this method yet, but a family member needed desperate help over the festive season and went ot the local emergancy unit of the Hospital and it had great results.

Looking forward to hearing from all other professionals out there.

 

Hello starfish3211,
I have just read your post and wonder why you are not permitted to use LA in Germany if you are not an NHS pod ?

In answer to your question, hypergranulation rarely subsides unless the cause, which is usually a nail sliver - is removed. If you cannot do this without LA I would suggest you refer to someone who can administer LA.

If the area is infected, then they need to see their GP for antibiotic cover.

regards

Catfoot

 

In Germany, Chiropody has just been officialy recognised in the last 10 years.. and they are very conservative to change here (especially in the medical profession) They regard administering LA to be striclty a DR thing!

I read an interesting article last night whereby the Association for Podiatry claims their training is equal to their British countrparts and they are hoping the treatment of PNA will soon be allowed to be done here by a Podiatrist instead of going to a Dr. Office.

Good grief , partial nail avulsions have been around for yonks! I had mine done in South Africa 24 years ago at my Podiatrist and his GP friend administered the LA and he did his continental with my toes and Phenol. I had a bad case of Proximal ung inc bi lateral.

When the ung. inc. is proximal and chronic, I send them straight to a GP for what they call "Emmert Plastik" here. At least we can buy an antibiotic cream here without prescription for the milder cases. Otherwise our hands as Podiatrists are a bit tied . Frustrating as hell, as these type of cases makes the job so interesting.
The worse the feet, the better for me. Just being a glorified pedicurist gets very boring!!:dizzy: