Discharge advice: Ingrowing toenails – partial or complete nail removal

Children and Young People’s Surgical Day Unit

Managing pain

It is normal for children and young people to be slightly sore after an operation. Please read the “Managing Pain after an Operation” leaflet. It contains lots of useful advice about how to help make your child feel more comfortable following surgery.

We advise you to give pain relief such as Paracetamol and Ibuprofen regularly for the first two days after surgery. Please follow the dose directions on the bottle and do not give more doses than stated. As your child starts to feel better you can stop giving these medicines regularly and give them “as required”.

What should I expect and what should I do?

Bruising and swelling may occur around the operation site. Elevating the foot (higher than the heart) by lying down or lifting the foot onto a pillow may help.

The surgeon will decide if the surrounding skin will have to be removed (wedge excision) or all of the toenail will be removed (nail excision). Both procedures will discolour the nail bed where the nail was. It will often have a grey or brown appearance. Please do not be concerned by this, it is normal.

Wound care

Your child’s wound will take 6 to 12 weeks to heal. This will vary considerably from one individual to another.

• It is important to keep the wound dressed until complete healing has occurred
• The wound will continue to ooze for several weeks. This is perfectly normal and should not be confused with an infection
• In order to avoid infection, it is important that dressings are changed regularly, ideally daily. You will be shown how to do this at your child’s follow up
• If you notice there is a discharge weeping through the dressing, do not increase the frequency of dressing changes simply double the layers of dressing used
• The surgeon will tell you where to go for your child’s first dressing change following the procedure. Some surgeons refer to the podiatry dressing clinic within 2 days, other surgeons may recommend your GP practice for nurse dressings changes instead

Dressing changes at home

If you are told to change dressings at home, firstly wash your hands.

• Gently remove the old dressing
• Try not to disturb the wound (if the dressing has stuck bathe the foot in warm water until the dressing can be removed easily)
• If your child wishes to have a shower, do this whilst the dressing is removed
• Do not dry the wound with a towel, sit your child with the foot elevated and allow the toe to air dry
• Once it is dry, reapply the dressing to the toe as directed by your practice nurse or clinic
• We do not advise your child to have a bath during the healing process. However, they can take showers. To do this, turn on shower and allow the water to run for 3 minutes before stepping in so that only fresh water that has not been in the shower pipes is running over the wound
• Keep shampoo, soap etc to a minimum and do not directly apply soap to the wound
• Limit the amount of time in the shower to a maximum 5 minutes

School, nursery and activities

• We advise 2 to 3 days off school depending on how your child feels.
• Encourage them to walk around from the start.
• During healing your child’s normal day-to-day activity should not be affected.
• Your child must wait until the toe is fully healed before swimming.
• Your child should not commence any sports, where the wound could be traumatised (for example, running, football, ballet), until fully healed.
• Older children should avoid vaping or smoking as this is bad for wound healing and will increase recovery time.

Follow up

Usually there is no need for a follow up appointment but if you are concerned by the long-term result of the surgery, please contact the Consultant Surgeon’s secretary or speak with you GP.

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850

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