Post Matrixectomy Wounds

Ingrown nails are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is usually the victim of this condition, but other toes can also become affected.

Development of ingrown nails is divided into the following 3 stages:

1. Nail-fold swelling (edema), redness (erythema), and pain with pressure.

2. Increased swelling, crusting and expressible pus at the nail fold (infection with drainage) and nail plate junction;

3. Chronic infection with prominent granulation tissue extending over the nail plate.

Causes of ingrown toenails include:

 

• Improper trimming - The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.
• Trauma - Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.
• Heredity - In many people, the tendency for ingrown toenails is inherited.
• Improperly sized footwear - Ingrown toenails can result from wearing socks and shoes that are tight or short.
• Nail Conditions - Ingrown toenails can be caused by nail problems, such as fungal infection or losing a nail due to trauma.

Treatment of ingrown toenails:

 

If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.

 

If you have an infected nail, any “self-help” attempt to remove any part of an infected nail should be avoided. Nail problems should be evaluated and treated by your podiatrist, who can diagnose and treat the ailment properly.

 

People with diabetes, peripheral vascular disease, or other circulatory disorders, when having nail problems, must avoid any form of self-treatment and seek podiatric medical care as soon as possible.

 

Generally for infected ingrown nail a podiatrist will cut out the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nail becomes a chronic problem, your podiatrist can perform a procedure called matrixectomy to permanently prevent ingrown nails. The corner of the nail that ingrows, is removed along with the root (matrix) of that piece of nail being destroyed (to prevent recurrence) by use of chemicals, laser, or by other methods.

 

Chemical matrixectomy with phenol and alcohol application (a P&A procedure) is one of the most common surgical procedures podiatrists perform. After the surgery, you will have some wound drainage, redness, swelling and tenderness.

 

Post matrixectomy wounds are sometimes difficult to heal due to many complex issues, including:

 

• Prolonged inflammation and pain due to chemical burn secondary to phenol use
• Excessive wound drainage (exudation)
• Redness & swelling (erythema & edema)
• Narrow, channel-type wound formed, rendering it susceptible to infection
• Poor blood circulation (ischemia)
• Poor patient compliance with rigorous post operation wound care involving frequent soaking
• Sensitivity to commonly used antibiotic ointments

Facing these complex issues and to improve the speed and quality of healing post matrixectomy wounds, under the guidance of a podiatrist one may consider using a multi-functional botanical therapy with these features:

 

• Including botanicals with broad-spectrum anti-microbial properties to protect wound bed from infection and to inhibit formation and growth of bacterial biofilms without harming nascent, delicate regenerating tissue;
• Employing naturally anti-inflammatory and analgesic botanicals to suppress prolonged inflammation and pain;
• Combination with botanicals that promote microcirculation of the low extremities to allow fast drainage and tissue regeneration;
• Ability to absorb wound fluid (exudate) to reduce maceration, and yet maintain a physiologically moist wound healing environment;
• Allowing painless, less frequent and easy dressing change;
• Healing wounds fast and effectively with maximum restoration of skin function and minimal scarring.

By using such a multi-functional botanical therapy, post matrixectomy wound care can be much easier and more convenient by avoiding frequent soaking, resulting in better patient compliance. In addition, those who are allergic to common antibiotic ointments such as Polysporin can use this natural alternative to achieve optimal healing.