Typically this is a blog and a topic I will usually discuss during the winter months when we are in our closed in shoes, as the weather warms up people will typically transition into their flip flops, sandals and open toe footwear to keep comfortable. I don’t know if it’s the pandemic or peoples determination to keep their COVID lockdown fitness regimen up, but I have had an influx of ingrown toe nails over the past few weeks.
More than half of them can be resolved typically in one treatment with minimal after care and self-care from home. Of the remaining less than half, some will need a few extra visits to correct the issue and lastly we will have a small stubborn cohort who will typically fail to respond to conservative treatment and are staring down the barrel of nail surgery to correct the issue.
In a clinic as large as SPC we will typically see patients in this latter category 4-6 times per week. We are all experienced in this type of procedure and in the event that the problem is a little beyond our scope or is quite advanced, we have a surgical podiatrist who attends bi-monthly, and is even more qualified and experienced to fix them.
This type of procedure sounds pretty terrifying and there is a fair degree of reassurance from our clinicians to the patient in order to allay fears that this is the best option and will likely yield the best success and outcome.
Because not everyone is treated at a large clinic like ours with our resources, they are often seeing their GP or a much smaller podiatry clinic with less experience in treating this condition as their primary caregivers. In no way are these other clinicians necessarily inferior, and their ultimate goal is the same as ours – a successful patient outcome. But sometimes it doesn’t hurt to ask a few questions to make sure you have the best person for the job.
If you are considering having ingrown toenail surgery, there are a few questions that I think are more than reasonable for you to ask your clinician to ensure that you are getting the best treatment available.
- What training have you undertaken for this procedure? This can vary considerably. The amount of training varies between professions. Podiatrists undertake extensive university and on-job training on nail surgery including correct injection techniques nail removal, phenolisation and wound dressing and often perform these procedures regularly. Your G.P may use a different method and perform it once or twice annually.
- How many surgeries have you undertaken and how often? Like everything, some clinicians have more experience than others. Some surgeons will do multiple surgeries a week whilst others can go months or even years without performing a surgery. There is nothing wrong with asking, and if you don’t feel confident in their ability – walk away!
- What redressing and follow-up care do you provide? Some doctors/podiatrists will do the surgery and discharge you for self-care. This is not our policy at SPC. We are almost obsessive about after care and we monitor patients very closely with 3 to 4 redressing appointments in the first 2 weeks, then a 3 and 6 month follow up check if required.
- Which technique do you perform and do you use phenol? Some clinics do partial nail avulsions (PNA’s) whilst others do wedge resections procedures. All of our Podiatrists here are skilled in the PNA method, and our Surgeon is equally skilled at both methods.
This is a highly specialised procedure with a very high success rate. If you need the surgery, ask as many questions as you want/need until you feel confident you are in the right place with the right person for the job. There is absolutely no obligation to follow through with anything if you are uncomfortable or uneasy with the idea, and your clinician will be able to guide you through what we would call ‘conservative care’ which is non-surgical ingrown maintenance. Here at SPC we will always be guided by what treatment we feel will give you the best outcome with minimal disruption. This will vary from person to person – there is no one size fits all method.
Some people prefer to come bi-monthly and have their nails treated. Whatever your preference, don’t be afraid to ask questions!
Have a wonderful week.