Procedure Name: Ingrown Toenail Removal
Indication: Pain, infection
Location: ________
Pre-Procedure Diagnosis: Ingrown Toenail
Post-Procedure Diagnosis: Same, removed
Informed consent: Procedure, alternate treatment options, risks, and benefits were thoroughly explained to the patient and informed consent was obtained before the procedure started.
Equipment for the procedure was set up.
PROCEDURE
An appropriate timeout was taken. The procedure and site were confirmed by patient and team.
-The area was prepped and draped in the usual sterile fashion. A digital block was done using ***cc of Lidocaine 1% without epinephrine for local anesthesia.
-The nail elevator (toenail spatula) was used to free the proximal nail fold from the nail plate below it.
-Then, the nail elevator was inserted under the nail plate of the ingrown part of the toenail to separate the nail plate from the nail bed. The nail elevator was sent all the way back to the nail matrix.
-Using the nail splitter, the toenail was cut to separate the ingrown portion from the healthy portion.
-A straight hemostat was then advanced under the free portion of the nail, as far as possible to grab the entire nail. It was then clamped down on this free nail segment and twisted and turned until the entire separated piece of toenail was removed. The entire piece was confirmed to be fully removed intact.
-Hemostasis was achieved through direct pressure.
The wound was copiously irrigated and ***packing placed. Estimated blood loss was ***cc. Triple antibiotic ointment was applied.
A dressing was applied to the area. Anticipatory guidance, as well as standard post-procedure care, was explained. Return precautions are given. The patient tolerated the procedure well without complications. Follow-up visit scheduled.