An Ingrown toenail (unguis incarnatus) can have many causes, such as deformed nails strong and sweating . People with diabetes or arterial disease strikes it often. But are mostly too tight shoes and the wrong cutting technique the cause. Often the shows already in young children when parents have cut them the toenails too strong and too deep, especially in the corners. As a result narrows the nail bed and offers a renewable nail not enough space – the corners press into the surrounding tissue and grow a. because that hurts like hell, lots of cutting the nail even shorter. It starts a cycle that can be difficult to break through. Hence the urgent appeal: Do not tinker on your own, but make a doctor’s appointment or pedicure! “Generally include ingrown nails in medical treatment,” says Annett Ullrich, nationally recognized medical podiatrist (podiatrist). This is especially true for diabetics and people with poor circulation. As long as no bleeding or purulent inflammation have formed, but podiatrists may intervene as a precaution.
The objective is further growth of nails – to direct in a different direction – usually the great toes. This are several options: the nail corrective brace (orthonyxie clasp), the tamponade – a roll of gauze fabric that can be soaked for example with a propolis solution – or the butterfly tubing, a cut plastic tube. “The latter two serve as a kind of placeholder between the nail and the nail bed,” said Annett Ullrich, also Vice President of the Central Association of Podiatrists and Chiropodists Germany (CPS).
But it is not always possible to solve the problem with one of these conservative methods. “Then a little surgery is required,” says senior physician Dr. Markus Regauer, Head of foot surgery at the Surgical Clinic of the Ludwig-Maximilians-University Munich. Stirring the pain of a inflammation of the nail bed and the nail edge here is already quite overgrown by erythematous, swollen tissue, must be a part of the nail, possibly also the related section of the nail matrix – the “root” – be removed. “It only takes a few minutes,” reassured Regauer. Against the small incision, the doctor checks the tetanus protection. The patient has no vaccination, the doctor is consulted. “We look at people who come to us with open wounds, as a supervisory body. If in doubt, we refresh the vaccination, “says Regauer. The risk of overdose usually do not insist. In addition, the surgeon clears the patient about the cosmetic result of the procedure used, because a Nagelverschmälerung can change the appearance of the foot.
First, the doctor will try a wedge resection. He cuts off only a small portion of the horn plate to get much from the nail. The inflammation goes deeper, he removed with a wedge excision, parts of the nail matrix. Particularly in interventions after a relapse of the doctor sees during surgery is not sure whether he has at this point the growth zone completely eliminated, possibly killing remaining parts from a phenol solution. “If even the smallest remnants remain there after the nail grows,” said Regauer foot surgeon.
According to the conservative treatment by podiatrists and also after surgery by a surgeon, the patient must be particularly careful about two weeks to deal with the foot. He should wear wide shoes with hard sole, not roll on the best sandals, and walking over the affected toe. “Crutches are usually not necessary,” says Markus Regauer. recently operated during this time should not sport driving, washing the feet with clean water and allow soap or shower gel come to the wound. “Do not apply ointment,” Regauer also exhorts. “This would inhibit the secretion drainage.”
While it is a cash benefit in the surgery, patients must pay the pedicure itself. Only a doctor’s prescription, the insurance pays the cost of the “complex podiatric treatment of insulin-dependent diabetic patients with diabetic foot ulcers in Wagner stage 0″.
The foot care usually costs between 25 and 35 Euro per treatment – an investment that pays off: On the one hand, because such a pampering treatment the feet is quite pleasant, on the other hand, the customer gets expert advice for the care of skin and nails. The most important is: never toenails too short, unlike the fingernails cut straight and defuse the corners with a file. Or, as the Podologin Ullrich puts it: “The pointed tip of the tip must go!”