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| Toenail Operation |
| << --- Simple Toectomy | Wedge Resection --- >> |
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These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT IS THE PROBLEM? Your toenail, as it grows from the quick, can cause trouble in two main ways. First, it can make the skin fold at the side very swollen and red (ingrowing toenail). Second, it can become very thick, curved and painful. Both these conditions can be treated by an operation.  WHAT DOES THE OPERATION CONSIST OF? The toe is made numb with an injection of local anaesthetic into its base. Occasionally a general anaesthetic is indicated. Then, for an ingrowing toenail, a sliver of nail and quick is cut out on each side that is tender and swollen. The nail then is a little narrower and the skin fold settles down. For a thick curved nail, the whole nail and all the quick are cut out so that instead of a nail there is just skin WHAT HAPPENS BEFORE THE OPERATION? Reception When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission. Welcome to the ward You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses. Visit by the anaesthetist If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had. Diet You can have an ordinary diet unless you are having a general anaesthetic in which case you must not eat or drink for 6 hours before. Timing of the operation The timing of your operation is pre-arranged so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing. Transfer to theatre You will be taken on a trolley to the operating suite by a nurse. You will be wearing a cotton gown, rings will be fastened with tape and removable dentures will be left on the ward. The operation You will be lying on an operating table. The anaesthetic injection will be given into your toe. This is uncomfortable, but the feeling soon wears off. Your toe will be cleaned with antiseptic and sterile towels will be draped around it. A tight band will be clipped around your toe to prevent bleeding. The operation is performed. This takes about 10 minutes per toe. The toe is covered with a dressing and a bandage. The tight band is removed and you go back to the ward. During the operation we will be talking to you to make sure you are comfortable. WHAT HAPPENS AFTER THE OPERATION? Coming round after the anaesthetic You will be wide awake unless you have had a general anaesthetic. Will it hurt? There is no feeling for an hour or so. After this you may need to take Aspirin or Paracetamol to control any pain, which gradually improves after a day or so. Drinking and eating You should be able to eat and drink normally. The wound and stitches The wound has a dressing which usually does not need to be removed for 7-10 days. You will need shoes with large toes to take the bandages, or shoes with no toes. Keep the dressing dry and as clean as possible. There are usually no stitches in the skin. The wound is held together underneath the skin and does not need further attention. Washing Wash around the dressing to avoid wetting it. How long in hospital? You should be able to go home within 1 hour of the operation. The nurses will talk to you about your home arrangements so that a proper time for you to leave hospital can be arranged. You will be given an appointment for a follow up visit in 2 weeks. Sick notes Please ask the nurses for sick notes, certificates etc. After you leave hospital You will be uncomfortable for a day or two and will be a little hampered by the dressings and the tender toe. Driving You can drive straight away if you can drive safely. After a general anaesthetic you must not drive for 24 hours. Work You should be able to return to a light job within 24 hours and a heavy job within 3 weeks. Complications Complications are rare and seldom serious. If you think that all is not well, please ask the nurses or doctors. Bleeding in the first 12 hours may be troublesome. Pain in the toe not controlled by aspirin or paracetamol or bad enough to keep you awake means you should contact the surgeon. The wound is tender and delicate for a week or so after the dressings are taken off. This rapidly gets better. GENERAL ADVICE The operation is a little uncomfortable, but should rapidly heal. If you have any problems or queries, please ask the nurses or doctors. |
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