Phenolic Ablation of Ingrown Toenails

The Problem: Previous procedures such as "Wedge Resection" and "Removal of Toenail" were painful, destructive and slowly healing treatments which did not offer permanent freedom from this common and disabling condition.

The modern approach is to remove (under local anaesthetic) only a 3mm section of nail where it is "ingrowing" (usually with an embedded spure), then to treat the exposed section of nail matrix (base) with Phenol for four minutes. This is said to give a near 100% success rate. Healthy tissue is protected by Vaseline and following treatment the Phenol is neutralised with alcohol. This last step seems to reduce the prolonged oozing reported by many surgeons as the "main drawback" (up to six weeks!).

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A review of the procedure was published recently [de Berker, David AR "Phenolic ablation of the nail matrix" Australasian Journal of Dermatology 42(1) 59-61 Feb 2001] which can be read on-line here.

We have found that a firm pressure dressing for 12 hours prevents bleeding after the tourniqet is released so it isn't necessary to elevate the foot for 24 hours and to have 10 days of only light activities (but your boss and/or partner don't need to know that!). No re-growth of the removed section of nail within 15 months, implies success but tight/pointed shoes and incorrect nail cutting is likely to produce a similar problem on the other foot!

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