Nail Surgery

At the Newcastle Foot Clinic we are fully qualified to carry out toe nail surgery. We offer two types of nail surgery; a partial nail avulsion and a total nail avulsion.

Total Nail Avulsion - A Total Nail Avulsion (TNA) is a minor surgical procedure undertaken in order to remove the entire nail plate and matrix (root). If phenol is used during the procedure then the nail will not re-grow.

This method of removing the nail and preventing it from re-growing is perhaps the least invasive of all the procedures used to remove toe nails and prevent their re-growth. The technique does not require stitches and the level of post-operative discomfort is minimal.
A toe nail that has been damaged may become permanently thickened and deformed making it both unsightly and likely to rub against the toe box of footwear. This will often result in the formation
of: recurrent haematomas (blood blisters) under the nail, ulcerations under the nail, possible corn/callus formation under the nail, possible bacterial and/or fungal formation under the nail, discomfort under the nail. A Total Nail Avulsion can be considered for patients with a combination of these factors.

The procedure involves ‘peeling’ the nail plate and matrix away from the nail bed. Phenol is then applied to the exposed nail bed. Phenol is used to destroy the cells that surround the matrix thus reventing the matrix from re-establishing itself and thus preventing new nail formation.

A Total Nail Avulsion takes around 8-12 weeks to fully heal.

Partial Nail Avulsion - A Partial Nail Avulsion (PNA) is a minor surgical procedure that involves the removal of a small strip of the side of the toe nail. A PNA is the perfect treatment for established
ingrowing toe nails (particularly with granulation tissue), and involuted nails that have a history of ‘digging in’. The procedure is quick, painless, and will cure any ingrowing toe nail / recurrently painful involuted nail (if it is undertaken by a Practitioner who is proficient in undertaking PNA’s ! )

Having numbed the toe with a local anaesthetic a small strip of nail is then removed from the affected side(s) of the nail plate with the corresponding piece of matrix (root). Phenol is then added to prevent the removed matrix from reforming; this will ensure the strip of nail that has been removed will not re-grow. In effect the nail is made slightly narrower than it was.

A PNA is an alternative to removing the entire nail (Total Nail Avulsion). In an otherwise healthy toe nail it would be an act of unnecessary vandalism to remove the entire nail unit when the ingrowing toe nail can be cured easily by just removing a small strip of nail. A Partial Nail Avulsion takes around 3-6 weeks to heal.

The Treatment Plan

When considering nail surgery the podiatrist will invite you for a Pre-op Assessment. This is to discuss the process, assess the nail, assess you are a suitable candidate for nail surgery and gain consent. This will be a 30 minute appointment.

• Your next appointment will be the nail surgery itself. This appointment will last approximately one hour.
• 4 – 7 days following the nail surgery your podiatrist will change the dressing on the toe, advise you how to change a dressing, supply the equipment required to do so and advise you when to do so. This appointment will last approximately 15 minutes.
• The podiatrist will see you 1 week after to change the dressing again and assess the healing of the toe.
• The podiatrist will then book you a dressing change appointment at 2 week intervals to monitor the healing of the toe until they are fully satisfied with the progress the toe has made.
• There is a small possibility of nail regrowth following surgery after the wound is healed and you have been discharged. We advise you contact the clinic and we will repeat the procedure free of charge

The Costs

The Newcastle Foot Clinic offers nail surgery as a treatment package including:

• Pre-op Assessment
• Nail Surgery
• Dressing Changes
• Second surgery If needed.

The price of the procedure is dependent on which procedure is suitable and number of nails requiring surgery. Your Podiatrist will be happy to discuss this with you at the Pre-op Assessment.

For pricing, please call: 0191 2618375