Podiatry - Nail Surgery Dressing

How can I help my wound to heal?

It is expected that it will take between 4-12 weeks for your wound to heal. A nail surgery wound can take longer to heal compared to other wounds as you are healing from a chemical burn.

Be aware that when you remove the dressing the day after having nail surgery it is normal for the toe to have been bleeding and there be some blood on this dressing.

It is normal for a nail surgery wound to bleed and weep some fluid for a couple of weeks after the procedure.

Your wound will heal fastest if you create the best conditions for new tissue to grow and take actions to prevent any infection.

Here’s what you should do:

• Wash your hands - The most important thing you and your caregivers can do to prevent infection is wash your hands. You should use soap and water, and wash before and after changing the dressing
• Keep a clean dressing on your wound - Wearing a dressing can help to minimise post operative infection and help absorb fluid that drains from the wound that could damage the skin around it
• Be careful - Protect the wound from trauma or injury. Don’t let anything touch it or bump it. It is advised to avoid any high impact or contact sports during the healing period, this includes going swimming

Signs of a wound infection

Wound infections are always a possibility after having nail surgery. Infection can happen at any time.

Please be aware of the following symptoms:

• Increased redness, pain or swelling
• An unpleasant smell
• Heat around the wound
• A thick yellowy or green discharge - It is normal for there to be a clear straw coloured fluid weeping from the wound in the first couple of weeks
• Feeling generally unwell with an increase in body temperature.

These signs and symptoms indicate that the wound may be infected and needs treating with antibiotics.

If you think you have an infection please contact your local Podiatry department on the contact details given to you by your podaitrist.

If you are worried about having an infection outside of Podiatry normal working hours please contact your out of hours GP on 111 or attend A&E.

Emergency Contact Details

Please refer to the emergency contact information your podiatrist has provided you with.

Changing your dressing

Before you start you will need:

• Water
• A clean work area
• Individually wrapped dry sterile dressings
• Surgical tape (if the dressing does not already have an adhesive border)
• A clean container
• A clean towel

Removal of the old dressing

Gently remove the old dressing being careful not to touch the part that has been in contact with the wound or the wound itself.

• If the dressing is stuck to the wound, soak it with water or saline and wait for the dressing to loosen. Allow a bit of time and avoid pulling as this will be painful and will damage the wound
• If the dressing is sticky or has a sticky border, avoid peeling it off. Instead, lift one or more corners of the dressing and stretch it horizontally along the skin surface to break the adhesive bond. Again, take your time and continue gently stretching until the entire dressing lifts

Step by step guide on applying a new dressing

• Clean your work area with sanitising wipes or warm water and detergent (washing up liquid)
• Wash your hands thoroughly with warm water and soap
• Using a clean container, fill with warm water
• Soak your toe for 5 minutes. (If you have had nail surgery to both feet it is advised you change the water and use fresh water for both foot soaks)
• Dry the surrounding skin being careful not to touch the wound directly
• Peel the backing off the dressing and apply to the wound. Be careful not to touch the wound itself or the centre of the dressing that will make contact with the wound. If required, secure the dressing with tape or a bandage if instructed to do so.

Do’s and Don’t’s

Do’s

• Monitor the wound and surrounding skin for any signs and symptoms of infection at each dressing change and report any concerns to your local Podiatry department using the contact details provided to you by your podiatrist.
• Keep the dressing dry
• Keep a dressing in place at all times
• Keep the dressing in situ while showering/bathing. It is okay for the dressing to become wet but you must change the dressing immediately afterwards and apply a new dry dressing
• Wear shoes that have enough room in them: Footwear should have enough depth and width to prevent increased pressure where the wound is

Don’ts

• Leave your wound uncovered
• Touch the wound or the surrounding skin
• Allow any pets or animals near the wound
• Apply any creams/lotions to the wound unless advised to do so by your Podiatrist
• Pick off any scab that forms. Leave this and allow this to come away naturally

Frequently asked questions

Where do I get more dressings from?

You will need to supply your own dressings for when you are dressing the wound after your surgery. Dressings can be purchased from most supermarkets with a health care section, most pharmacies and also online. If you feel you may struggle to provide your own dressings, then please speak to your podiatrist.

How long does it take for a wound to heal?

Every wound is unique but it is expected that the wound will heal anytime between 4-12 weeks after having nail surgery.

What do I do if I think the wound is infected?

Contact the Podiatry department as per the emergency contact information you are provided with.

How will I know if the wound is healing well?

The fluid from the wound will become less over the coming weeks The wound bed will start to turn from a red colour to pink and a scab will start to form. Some patients find it useful to take a picture of the wound at each dressing change; you can do this on a mobile phone that has a camera or by using a digital camera.

What do I do if my dressing is leaking but it isn’t due to be changed?

If fluid from the wound has leaked through the dressing it is important that the dressing is changed and a new one applied.

How do I know when to stop dressing the wound?

You can stop dressing the wound when there is no fluid on the dressing removed for 3 consecutive days and the area of the wound is dry.

Will I be seen for a follow up appointment?

In most cases a follow up appointment after nail surgery isn’t usually required however this will be decided on an individual basis. We might want to book a follow up if you have a health condition that could delay the healing of the wound or put you at increased risk of infection. Your Podiatrist will discuss this with you.

References:

National wound care strategy programme 30/03/2020. Shared Care for Wounds.31/03/2020.

www.nhs.uk

Royal College of Podiatry (2021) version 3. ‘Nail Surgery Guidelines’ www.rcop.org.uk