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Ingrown toenail / paronychium.

Ingrown toenail / paronychium. HEIFETZ PROCEDURE. Excising an ingrowing toenail. (Partial resection). 2. Applying a tourniquet. 1. Ring block (without adrenaline). 3. Incising through the nail and nailbed. 4. Removing a wedge of nail and granulomatous tissue. 5. Lifting the nail segment.

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Ingrown toenail / paronychium.

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  1. Ingrown toenail / paronychium.

  2. HEIFETZ PROCEDURE Excising an ingrowing toenail. (Partial resection)

  3. 2. Applying a tourniquet. 1. Ring block (without adrenaline). 3. Incising through the nail and nailbed. 4. Removing a wedge of nail and granulomatous tissue.

  4. 5. Lifting the nail segment. 6. Excising the germinal matrix. 7. The wedge of has now been removed. 8. Curettage to ensure there is no residual matrix.

  5. 9. Application of a topical spray. 10. Suturing the angular portion of the wound. 11. Apply an adequate firm dressing.

  6. ZADEK’S PROCEDURE Excising an ingrowing toenail. (Permanent removal)

  7. 1. Applying a tourniquet after a local block. 2. Incising the nail margin. 3. Reflecting the flap proximally. 4. The nail lifted clear.

  8. 5. Excision of the germinal matrix. 6. The intact germinal matrix as removed. 7. The clean nailbed. 8. Angular sutures.

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