Recovery from Paronychia: Is My Treatment Plan Effective?

Inquire about the recovery status after nail clipping in cases of paronychia?

Hello Dr.
Li, I developed paronychia and went to a surgeon to have my nails trimmed.
After the trimming, I had two follow-up appointments with the doctor.
However, each time the doctor changed the dressing on my foot, he only used iodine-soaked cotton to pack the area and then told me to come back in two days for another dressing change, advising me to avoid water.
He only prescribed pain medication for the pain.
I want to know if this is the correct treatment.
I later felt that there was no improvement with the medication and dressing changes, so I stopped seeing that doctor.
Instead, I used a topical ointment prescribed by a dermatologist for my toenails before I went to the surgeon.
I applied the ointment daily and kept my foot dry.
However, every time I removed the gauze, there was yellow fluid on it, and it had a somewhat foul odor.
I am worried that this might indicate an infection or that the nail wasn't trimmed properly, as my foot still hurts a bit.
I want to ask the doctor if this is normal during the recovery process for my toenail, or if I should make an appointment to see a doctor.

Niming, 20~29 year old female. Ask Date: 2016/03/10

Dr. Li Zhonghuai reply Surgery

Hello! The surgical approach is to allow the toenail to grow back on the nail bed as quickly as possible, but it will take at least a month, so patience is required.
If there is a foul odor, it may indicate paronychia, and the affected side may need to be completely removed.
As for the dermatological ointment, it is unknown.
I recommend that you return to the surgical department, and daily use a sterile cotton swab with saline solution to clean the wound, removing all the yellowish debris.
The choice of ointment should be determined by your physician.
Changhua Hospital cares about you!

Reply Date: 2016/03/10

More Info

Recovery from paronychia, which is an infection of the skin around the nails, can be a complex process that requires careful management. Based on your description, it seems that you have been following a treatment plan that includes regular follow-ups with a surgeon and the use of topical medications prescribed by a dermatologist. However, there are several important considerations regarding your treatment and recovery.

Firstly, the initial treatment you received from the surgeon, which involved trimming the nail and applying iodine-soaked cotton for dressing, is a common approach for managing paronychia. The iodine helps to disinfect the area and prevent further infection. However, the effectiveness of this treatment largely depends on the severity of the infection and whether there is any underlying issue, such as an ingrown nail or a foreign body that may need to be addressed.

The fact that you are experiencing yellow discharge with a foul odor suggests that there may be an ongoing infection. This is not uncommon in cases of paronychia, especially if the infection has progressed or if there is necrotic tissue present. The presence of pain and discharge indicates that the infection may not be resolving as expected, and it is crucial to monitor these symptoms closely.

While it is understandable that you may have felt discouraged by the lack of improvement after your follow-up visits, it is important to recognize that persistent symptoms warrant further evaluation. If the discharge continues to be foul-smelling and you are experiencing pain, it is advisable to seek medical attention again. A healthcare provider may need to assess the area for any signs of abscess formation or other complications that could require drainage or additional interventions.

In terms of your current self-treatment with the topical medication prescribed by the dermatologist, it is essential to ensure that the medication is appropriate for your condition. While topical treatments can be effective, they may not be sufficient if there is a significant infection or if the nail itself is contributing to the problem. Additionally, keeping the area dry and avoiding water exposure is crucial, as moisture can exacerbate the infection.

To summarize, while some discharge and discomfort can be part of the healing process, the presence of foul-smelling discharge and persistent pain are concerning signs that should not be ignored. It is highly recommended that you return to a healthcare provider for a thorough evaluation. They may consider performing a culture of the discharge to identify the specific bacteria involved and adjust your treatment plan accordingly. In some cases, oral antibiotics may be necessary to effectively manage the infection.

In conclusion, while your initial treatment plan had merit, the ongoing symptoms suggest that further intervention is needed. Do not hesitate to seek medical attention to ensure a proper recovery from paronychia and to prevent any potential complications. Your health and well-being are paramount, and timely medical care can make a significant difference in your recovery process.

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