Post-Nail Removal Concerns: Pain, Discoloration, and Next Steps

Post-Operative Issues After Nail Removal

Hello Doctor: On July 28, I accidentally got a wood splinter stuck in my right pinky toe.
The emergency physician decided to remove the nail and extract the splinter.
Three days later, it no longer hurts when exposed to water.
Since the nail removal, I have been disinfecting daily with iodine.
However, there is still pain when pressure is applied to the middle part of the toe, and I can only wear flip-flops.
I would like to know if this indicates that the splinter was not completely removed.
Currently, the color of my toe is slightly purplish, a darker shade.
Is this normal bruising, or would you recommend seeing a surgeon for further evaluation? Thank you!

Mika, 10~19 year old female. Ask Date: 2016/08/07

Dr. Li Zhonghuai reply Surgery

Hello! It is too early to come into contact with water in three days; you need to wait until the nails have healed before doing so.
Contacting water now may lead to infection and cellulitis.
It is recommended that you return to the surgical department as soon as possible.
Take care! Changhua Hospital cares about you!

Reply Date: 2016/08/07

More Info

After a nail removal procedure, it is not uncommon to experience some discomfort, discoloration, and other symptoms as part of the healing process. Based on your description, it seems that you are dealing with a few concerns related to pain, discoloration, and the overall healing of your toe after the incident with the wood splinter.

Firstly, the pain you are experiencing when pressure is applied to the middle section of your toe could be due to a few factors. After nail removal, the underlying nail bed is exposed and can be sensitive as it heals. It is also possible that there may still be some residual inflammation or irritation in the area. If the pain persists or worsens, it could indicate that there might be an issue such as an infection or that some foreign material (like the wood splinter) may not have been completely removed.
Regarding the discoloration you mentioned, a purple or dark color in the toe can be a sign of bruising or hematoma, which is common after trauma to the area. Bruising occurs when blood vessels break and leak blood into the surrounding tissues, leading to the characteristic discoloration. This is generally a normal part of the healing process, especially after a procedure like nail removal. However, if the discoloration is accompanied by increased swelling, warmth, or redness, it could suggest an infection, and you should seek medical attention.

In terms of next steps, here are some recommendations:
1. Monitor Symptoms: Keep an eye on the pain and discoloration. If the pain becomes severe or if you notice any signs of infection (such as pus, increased redness, or fever), it is important to seek medical attention promptly.

2. Footwear: Since you mentioned that you can only wear flip-flops, it’s advisable to continue wearing open-toed shoes that do not put pressure on the affected area until it heals. Avoid tight shoes that may exacerbate the pain.

3. Wound Care: Continue to keep the area clean and dry. If you are using iodine for disinfection, ensure that you are not overdoing it, as excessive use can irritate the skin. You might want to consider switching to a gentler antiseptic if irritation occurs.

4. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation. However, consult with your healthcare provider before taking any medication, especially if you have other health conditions or are taking other medications.

5. Follow-Up Appointment: Given your ongoing symptoms, it would be wise to schedule a follow-up appointment with a healthcare provider, preferably a podiatrist or an orthopedic specialist. They can assess the healing process, check for any remaining foreign material, and ensure that there are no complications.

In conclusion, while some pain and discoloration can be normal after nail removal, persistent or worsening symptoms warrant further evaluation. It is always better to err on the side of caution when it comes to potential infections or complications. Your healthcare provider will be able to provide the best guidance tailored to your specific situation. Take care, and I hope you have a smooth recovery!

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