What should I do if my nails grow into the flesh after I cut them?

In daily life, many people cut their nails too deep, causing the nails to grow into the flesh. This makes people's lives very inconvenient and painful. So what should you do if your nails grow into the flesh after you cut them? In fact, the best treatment method is surgery.

1. General treatment

When the inflammation is mild, it can be treated locally.

① Routine disinfection, no anesthesia required.

②The operator pinches both sides of the affected toe.

③ The operator uses a scalpel or pedicure knife in his right hand to pick out the stump of the toenail that has been embedded in the soft tissue of the nail groove. Once the ingrown toenail is removed, the pain will be eliminated immediately.

④After the operation, wrap the wound with iodine disinfectant gauze and then bandage it. Change the dressing every other day, and the wound will usually heal after 3-4 days.

2. Surgical treatment

Simple partial or complete removal of the nail plate: The operation is simple and quick, with satisfactory short-term efficacy, but the recurrence rate of this operation can reach 73%.

① In some cases, nail removal has not been successful even after more than 4 attempts, and the nail has become more and more deeply embedded, with severe nail deformation and malnutrition. Later, people discovered that cohesion of nail edge tissue was an important cause of the recurrence of ingrown toenails. Partial nail removal is now mostly used as the basis for combined surgery or complex surgery.

Partial or complete removal of the diseased nail + treatment of the soft tissue at the nail edge, targeting the cohesion of the nail edge.

② The treatment methods of diseased nail part + diseased nail edge tissue resection and nail extraction + local skin shrinkage were significantly better than simple nail extraction, with recurrence rates of 8% and 21.17% respectively.

The surgery focuses on the nail bed. The occurrence of ingrown toenail is related to the nail bed, and it is pointed out that the nail bed must be removed.

③The growth of toenails relies on the nail bed, especially the germinal matrix of the nail bed. The growth and extension of toenails are integral to the nail bed. Pathological examination showed that patients with ingrown toenail also had interrupted transition from the nail bed to the nail fold epithelium, excessive filling of inflammatory granulations, and focal scar formation at the nail groove.

Especially after simple nail extraction, due to the lateral stress acting on the nail edge, the nail bed loses the support and shaping of the nail plate, and the curvature of the nail bed is significantly increased. Therefore, only by removing the overgrown nail bed that is bent toward the ventral side of the toe and restoring the normal continuity between the nail bed and the nail fold epithelium can ingrown toenails be cured. The nail groove reconstruction surgery designed accordingly has a cure rate of 95.15%.

④CO2 laser can also be used to burn some diseased nails and nail beds, which also achieves good results.

⑤ The radical resection of the nail bed is performed to cut off the distal end of the distal phalanx at the root of the nail. There is no recurrence, but the trauma is large, destroying the normal shape of the big toe, greatly affecting the appearance, and is not accepted by patients.

The surgery focuses on treating the nail matrix: completely removing the bad growth tissue of the nail (the nail matrix of the diseased part of the nail), eliminating the cause of the ingrown nail, and achieving the purpose of radical cure. Such as onychotomy + partial nail matrix destruction, onychotomy + matrix removal.

Combined treatment of the nail bed and nail matrix: This method is now widely used. The basic principle is to remove the deformed parts of the nail matrix and nail bed and retain the part with normal growth shape. The cure rates of combined nail matrix and nail groin correction, nail extraction plus laser carbonization of the nail bed and nail matrix were 68%, 78.16%, 98.17% and 89.17% respectively〔10,11,12〕.

Surgery to improve nail groove drainage and increase nail groove space: such as finger pulp plasty and wedge resection of paraungual soft tissue, to flatten and shallow the nail groove and eliminate potential dead space. The trimming technique involves extending the nail groove toward the root of the nail, removing the ingrown nail, and applying a medicated bandage, but the efficacy reviews vary.