Impact of Nail Removal on Wound Healing and Recovery Time

The wound has opened after nail removal?

Hello, Doctor.
Two weeks ago, I had a partial nail avulsion due to paronychia, where 1/5 of my nail was removed at a surgical clinic.
The night before last, while changing the dressing, I accidentally removed the scab (the wound has healed but is not fully recovered).
The next day, I returned for a follow-up and asked the doctor if this would have any impact, and he said it wouldn't.
However, he thought there was debris at the site of the nail removal and vigorously swabbed it with a sterile cotton swab.
When I changed the dressing that evening, I noticed that the area where I accidentally removed the scab (which was also where he applied pressure) had cracked open and was bleeding.
I would like to know if this will affect the healing of the wound and the growth of my nail.
Also, when can I get my wound wet? The doctor who performed the nail avulsion initially said I could get it wet after three to four days, but I have seen other inquiries and responses from doctors indicating that the duration is longer, which has made me hesitant to get it wet until now.
I apologize for the many questions and the lengthy message.
Thank you for your help!

Lynn, 20~29 year old female. Ask Date: 2023/09/08

Dr. Li Zhonghuai reply Surgery

Hello! After debridement, there will still be a dirty film on the surface the next day that needs to be removed.
The cleaner the nail bed, the faster the new toenail will grow.
So the scab you mentioned is actually this dirty film that needs to be cleaned off.
As for exposure to water, you should avoid tap water until the new toenail membrane has formed.
Generally, it takes about two weeks for most people, but those with chronic illnesses or who smoke or drink alcohol may require a longer time.
You can buy a whole box of large sterile saline solution to soak your feet.
Take care! Changhua Hospital cares about you!

Reply Date: 2023/09/08

More Info

The impact of nail removal on wound healing and recovery time can be significant, particularly when it comes to the healing of the nail bed and the surrounding tissue. In your case, where a portion of the nail was removed due to paronychia (nail fold infection), it is essential to understand the healing process and the factors that can influence it.

When a nail is removed, the underlying nail bed is exposed, which can lead to increased sensitivity and a higher risk of infection. The healing process typically involves several stages: hemostasis (stopping the bleeding), inflammation (where the body responds to injury), proliferation (where new tissue forms), and remodeling (where the new tissue matures). The time it takes for a wound to heal can vary based on several factors, including the extent of the injury, the individual's overall health, and how well the wound is cared for.

In your situation, the accidental removal of the scab can disrupt the healing process. Scabs serve as a natural barrier against bacteria and protect the underlying tissue as it heals. If the scab is removed prematurely, it can expose the wound to potential contaminants, leading to a risk of infection or delayed healing. The bleeding you experienced after the scab was removed indicates that the tissue was still fragile and not fully healed.

Regarding your question about when you can safely expose the area to water, it is generally advisable to keep the wound dry and covered until it has fully healed. While some healthcare providers may suggest that it is safe to expose the area to water after three to four days, this can vary based on the individual case. It is crucial to follow your healthcare provider's specific instructions, as they are familiar with your particular situation. If you have concerns about the wound healing or if you notice any signs of infection (such as increased redness, swelling, warmth, or discharge), it is essential to seek medical advice promptly.

As for the growth of the nail, it can take several months for a nail to fully regrow, depending on the individual's nail growth rate and the extent of the nail bed injury. Typically, fingernails grow about 1/8 inch (3 mm) per month, while toenails grow more slowly, at about 1/16 inch (1.5 mm) per month. If the nail bed was damaged during the removal process, it could affect the appearance and growth of the new nail. In some cases, the new nail may grow back irregularly or may take longer to return to its normal state.

In summary, while the accidental removal of the scab may impact the healing process, it is essential to monitor the wound closely and follow your healthcare provider's recommendations. Keeping the area clean and protected, avoiding unnecessary trauma, and being cautious about exposure to water will help promote healing. If you have any further concerns or if the wound shows signs of infection, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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