Post-Surgery Pain and Recovery After Nail Removal

Four days ago, I went to the hospital to have part of my nail removed due to paronychia recurrence?

In November 2019, I went to the hospital for treatment of paronychia on my right big toe, during which the nail was removed (excision from the nail bed root).
As a result, it recurred in May of this year, with swelling of the big toe that did not become purulent but was bleeding, so I went to another hospital for treatment.
The doctor did not excise from the nail bed root but instead removed a segment of the nail above the nail bed.
There was no bleeding during the procedure, and the doctor only prescribed Betadine ointment, instructing me to change the dressing twice daily.
Currently, I am on the fourth day, and I have not gotten the area wet while showering, maintaining dryness.
However, walking or touching the big toe still causes pain.
Is this situation normal? I feel that there are no signs of reduction in swelling in the affected area...

zhāngyú, 20~29 year old female. Ask Date: 2020/05/26

Dr. Ke Fangxu reply Surgery

In general, if the toenail is removed adequately for ingrown toenail, swelling and pain should subside in about three days.
If there is currently no significant pain, you can observe it for a few more days.
However, if redness, swelling, pain, or discharge persists, it is advisable to consult a physician to determine if further treatment of the nail matrix is necessary.

Reply Date: 2020/05/26

More Info

Post-surgery pain and recovery after nail removal can be a complex process, particularly when dealing with conditions like ingrown toenails or nail bed infections. In your case, it seems you have undergone two separate procedures for your right big toe, with the first involving the complete removal of the nail from the nail bed root and the second involving the removal of a portion of the nail above the nail bed.
Firstly, it is important to understand that pain and swelling after any surgical procedure, including nail removal, are common. The body undergoes a healing process that can involve inflammation, which is a natural response to injury or surgery. In your situation, the fact that you are experiencing pain and swelling four days post-surgery is not unusual. The pain can be attributed to several factors:
1. Surgical Trauma: The procedure itself causes trauma to the tissues, which can lead to pain and swelling as the body responds to the injury.

2. Inflammation: After surgery, the body initiates an inflammatory response to promote healing. This can result in swelling and tenderness in the affected area.

3. Nerve Sensitivity: The nerves in the area may be more sensitive after surgery, leading to increased pain perception, especially when pressure is applied or when walking.

4. Infection Risk: Although you mentioned that there is no pus and the area is not infected, it is still crucial to monitor for any signs of infection, such as increased redness, warmth, or discharge. If these symptoms occur, it would be essential to contact your healthcare provider.

Regarding your current care regimen, it is good that you are keeping the area dry and following the doctor's instructions for applying the iodine ointment. Keeping the wound clean and dry is vital for preventing infection and promoting healing.
As for the swelling, it may take some time for it to subside. Swelling can persist for several days to weeks after surgery, depending on the extent of the procedure and individual healing rates. Here are some additional tips to aid your recovery:
- Rest: Avoid putting excessive weight on the affected foot. If possible, elevate your foot when sitting or lying down to help reduce swelling.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation. However, consult your doctor before taking any medication.

- Follow-Up Care: Ensure you have a follow-up appointment with your healthcare provider to assess the healing process. They can provide guidance on when to resume normal activities and whether any additional treatments are necessary.

- Monitor Symptoms: Keep an eye on the surgical site for any changes. If the pain worsens, or if you notice any signs of infection, contact your healthcare provider immediately.

In summary, while some pain and swelling are expected after nail removal surgery, it is essential to monitor your symptoms closely and follow your doctor's care instructions. Healing can take time, and patience is key. If you have any concerns about your recovery or if symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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