Your toenail surgery will take place at Teddington Memorial Hospital. When you arrive, go to the Outpatient Reception (Purple Zone).

Important

You will not be able to drive yourself home after your surgery. Arrange for someone to collect you, or take a taxi home.

Try to avoid walking home or taking public transport, so that you can rest your foot.

Preparing for surgery

Read the following guidance carefully.

Children under the age of 16 who are due to undergo toenail surgery must be accompanied by a parent or legal guardian. This is because the hospital will ask for signed consent for the surgery to go ahead.

Food and drink

  • We recommend you eat a light meal before your surgery. This can be your usual breakfast and/or lunch on the day of surgery.
  • Do not have alcohol on the day of surgery.

What to bring

  • Bring a list of any medications that you are currently taking.
  • Bring any medications that you may need on the day, for example asthma inhalers.
  • Bring a pair of loose-fitting slippers, open-toed sandals or flip-flops. These will allow room for the toe dressing you will be wearing after surgery.
  • It is a good idea to bring something relaxing to read or listen to. If you bring this on a device, make sure you download it before you arrive.

foot and flip flop.jpg

On the day

When you arrive, you will meet your podiatrist. A podiatrist is an expert on foot and ankle health.

  • The podiatrist will check your medical history and ask about any medications that you currently take. 
  • They will examine your toe(s).
  • They will explain the surgery to you and ask you to give your consent.

During surgery 

You can expect the podiatrist to do the following during your surgery.

  • They will inject a local anaesthetic into the base of your toe, on both sides. This will make sure you feel no pain when they operate on your toe.
  • Your toe will quickly start to tingle and feel numb.
  • They will place a rubber tourniquet (stretchy band) around the toe.
  • They will operate to remove the nail/piece of nail that is causing you problems.
  • You may feel pressure on your toe as the podiatrist works, but you will not feel pain.
  • They will treat the root of the nail using a chemical called phenol. This will stop the nail/piece of nail from growing back.
  • They will remove the tourniquet and put a dressing on your toe.

Immediately afterwards

  • Your toe will feel numb for a few hours after surgery. Be careful not to damage it.
  • Do not drive for 12 hours after your surgery. Numbness in your toe will affect your driving and your car insurance may not cover you if you have an accident.
  • Your toe is likely to feel painful when the numbness has worn off. Take paracetamol for the pain and try to rest with your foot raised up, for at least 6 hours.
Do not take aspirin or anti- inflammatory drugs (such as ibuprofen). They can increase the risk of bleeding.
  • Keep your toe dressing dry and in place, until we advise you to redress it (usually after 2 days). You can then replace the large dressing with a much smaller one. Some patients may need a redressing appointment. Your podiatrist will discuss this with you, if needed. 
  • Wear wide-fitting shoes or trainers until your toe has healed.

When to seek medical help

Get in touch with us (see Contacts) if you experience heavy bleeding from your toe(s).

Risks and side effects

The following are possible risks and side effects of nail surgery (listed in order: most common to most rare).

  • post-operative bleeding
  • post-operative pain
  • delay in healing
  • wound infection
  • phenol burns (a mild chemical burn caused by phenol)
  • nail/piece of nail may grow back
  • altered sensation in the toe
  • altered appearance/growth of nail or surrounding area of toe
  • remaining nail detaches from nail bed completely (may be permanent loss of nail)
  • permanent post-anaesthetic numbness of toe
  • Complex Regional Pain Syndrome (CRPS) - a rare condition where pain increases after a procedure
  • allergic reaction to anaesthetic (anaphylaxis).

If you have any concerns, speak to your podiatrist.

More information

Kingston Hospital information on toenail surgery after-care

Contact information

Podiatry and diabetic foot protection service (Richmond)
Monday to Friday, 9am to 4pm

 

Out of hours, contact your GP or go to your nearest Emergency Department (A&E).
Take your post-operative information letter with you.

Telephone:

Podiatry and diabetic foot protection service (Richmond): 020 8614 5435

Email: krft.communitypodiatry@nhs.net