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complications


Notes:

The main issues after wedge resections are pain or bleeding.
Excessive pain may mean ischaemia, this needs to be checked. Most patients require some analgesia such as Panadeine Forte.
Infection – If the patient is on antibiotics these should be continued to the end of course. Following the procedure infection can be a complication as signified by increasing pain and erythema. This will need treatment with antibiotics. It there is any necrotic tissue this will require debridement drainage. Incidences of this type of problem is low.
Recurrent – it is difficult to estimate as there are very few well-controlled trials. There is however a recurrence rate.
Later problems – this may include nail spike growing out. This can be dealt with in a similar way to a wedge resection.
Occasionally an abscess may develop one or two months later. It can be due to a sliver of skin remaining embedded or a portion of the nail bed, and this behaves like any plantation dermoid cyst. This is a foreign body and results are infection. Drainage under digital block and removal of the offending material usually resolves the matter.
Occasionally the patient complains of pain, the nail grows back particularly after the removal of the whole nail. This pain is at the distal tip of the toe and the nail is pushing against the raw skin. The nail needs to be trained to protrude upwards.
Following wedge resection the patient is given advise in a nail care – the trimming, the avoidance of pressure and general care. The whole area should not be exposed to dirty socks.