Matrixectomy - Post Op After Toenail Chemical Destruction
Dr. Peter J. Bregman, DPM
Top Rated Podiatrist in Las Vegas
Matrixectomy and Post Op Instructions After Toenail Chemical Destruction
This in office procedure is painless once the toe is anesthetized. It takes less than a few minutes to complete the procedure.
Once the toe is numbed up, the portion or portions of the nail that are causing the pain are removed using special sterilized instruments designed specifically for this procedure.
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The bandage you have on the toe should be left in place until the next day. There is no need to remove it. You can expect to see some bleeding which is normal. If there is too much bleeding you can change the dressing.
The anesthesia used during your procedure should last for at least 6 hours but could be as long as 24 hours. It is very important that you keep the area where the toenail was removed clean and open. If the whole toenail was removed you have to keep the sides open and don’t allow them to close. If you only had one side done keep that groove where the nail was removed open to allow drainage. The best way to do this is to wash the toes in warm water with soap and then take a Qtip and dig out any debris/clean the gutter. You want to keep this area from closing so that the chemical(Phenol) used to kill the root can drain out.
The chemical used either phenol or sodium hydroxide will cause some redness and drainage to the surgical site. This is normal. If you see a lot of redness or drainage with pain then you should call the office, as there may be an infection or you are having a reaction to the chemical.
You will begin soaking 12 hours after the procedure two to three times a day for 10 minutes in warm salt water. 2 tablespoons in 1 quart of water.
Normally we prescribe Corticosporin Otic solution to be applied twice a day as drops, which is a topical medication but if you cannot purchase it for some reason you can use Silvadene, Bacitracin, or Neosporin and add a little 1% hydrocortisone cream (you can buy at pharmacy). You only use a small amount on the area about the size of a small pea. For the first few days use gauze to cover the toe instead of a Bandaid, this allows the toe to breath. Once the drainage is minimal you can switch to a Bandaid. Keep it covered at all times for the first 34 days with gauze. After this you can use a Bandaid, and at night you should leave it uncovered and open to air to allow it to breath.
You should make sure you have a follow up appointment to see the doctor at 23 weeks to make sure it is healing properly and that there is no regrowth of the nail.
The procedure is 95% effective but sometimes the nail can regrow even partially and this can cause some pain. If this happens the procedure can be done again and usually is effective. In some cases you may also be prescribed an antibiotic if there is concern about possible infection especially in Diabetics. If you have any concerns or question please call the office or email Dr. Bregman at DrBregman@bregmanfance.com
Please make sure we have your current pharmacy information.