Nail Surgery

When Is Surgery Recommended?

Minor nail surgery is commonly considered for ingrown toenails (Stage 2–4) when they are recurrent, severe or infected.

You may be advised to consider nail surgery if:

• You experience repeated painful episodes affecting the same nail edge
• Infection continues to return despite appropriate treatment
• There is significant swelling or granulation tissue
• You have persistent or ongoing pain
• The nail is significantly curved and repeatedly grows into the surrounding skin
• Your symptoms are affecting work, exercise, or everyday activities
• You are unhappy with the appearance of the nail

Nail Surgery: PNA or TNA

Nail surgery is performed under local anaesthetic, meaning the toe is completely numb and the procedure should not be painful.

A Partial Nail Avulsion (PNA) or Total Nail Avulsion (TNA) is a straightforward and highly successful procedure used to remove the nail, or part of the nail, responsible for the problem.

Where appropriate, a chemical called phenol can then be applied to the nail matrix to prevent the problematic section of nail from growing back. Our priority at Podiatry Care Bristol is to achieve a successful clinical outcome while maintaining the best possible cosmetic appearance.

What to Expect from a PNA?

During a Partial Nail Avulsion:

• The problematic section of nail is carefully removed, while preserving as much healthy nail plate as possible.
• No cutting of the skin or stitches are normally required.
• Phenol may be applied to prevent the affected nail edge from growing back, providing a long-term or permanent solution.
• You can walk immediately after the procedure. However, we recommend going home afterwards and keeping the foot or feet elevated to help reduce discomfort and swelling.

Total Nail Avulsion (TNA)

A Total Nail Avulsion involves removing the entire nail rather than just the problematic section.

This may be recommended in cases involving extremely thickened, fungal, involuted, or significantly ingrown toenails.

Where phenol is used, the procedure is intended to provide a permanent solution. TNA with phenol has a reported success rate of 96%. However, in some cases, we may choose not to use phenol, allowing the nail to grow back.

Evidence-Based Ingrown Toenail Treatment

With access to the latest evidence-based techniques and treatment approaches, we provide safe and effective care for ingrown toenails, whether your condition is uncomplicated or infected.

Our podiatrists will guide you through your treatment options and recommend the approach most appropriate for your individual circumstances.