![]() In most cases, these physicians will remove both sides of a toenail (even if one side is not currently ingrown) and coat the nail matrix on both sides with a chemical or acid (usually phenol) to prevent re-growth. Some physicians will not perform a complete nail avulsion (removal) except under extreme circumstances. A wide wedge resection, with a total cleaning (removal) of nail matrix, has a nearly 100% success rate. Some use "lateral onychoplasty," or "wedge resection," as the method of choice for ingrown toenails. As a follow-up, a physician may prescribe an oral or topical antibiotic or a special soak to be used for about a week after the surgery. The patient is allowed to go home the same day and the recovery time is anywhere from two weeks to two months barring any complications such as infection. The entire procedure may be performed in a physician's office in approximately thirty to forty-five minutes depending on the extent of the problem. This process is referred to as a "wedge resection" or simple surgical ablation and is not permanent (i.e., the nail will re-grow from the matrix). The physician will perform an onychectomy in which the nail along the edge that is growing into the skin is cut away ( ablated) and the offending piece of nail is pulled out. Antibiotics are not needed if surgery is performed. As an alternative, one may use 10% sodium hydroxide which is less toxic or trichloroacetic acid which may give faster healing time. If the ingrown toenail recurs despite this treatment, destruction of the germinal matrix with phenol is recommended. The initial surgical approach is typically a partial avulsion of the nail plate known as a wedge resection or a complete removal of the toenail. If conservative treatment of a minor ingrown toenail does not succeed or if the ingrown toenail is severe, surgical management by a podiatrist is recommended. Surgical treatments of ingrown toenails include a number of different options. A toe post wedge resection with an image of the removed nail Surgical procedures for nail disorders A resected wedge from the left side of the left big toe, shown to scale Toe healing process after nail removal
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