Podiatry - Ingrown Nail/Paronychia
Orthopedics & Podiatry Main Menu
- Redness, warmth,
tenderness and exudate coming from the areas adjacent to the nail plate.
Initial Diagnosis and Management
- History and physical
- In chronic infection
appropriate radiographic (foot or toe series to rule out distal phalanx
osteomyelitis) and laboratory evaluation (CBC and ESR).
Ongoing Management and Objectives
- Primary care should
consist of Epsom salt soaks and antibiotics for ten days as needed for
- If Epsom salt soaks and
antibiotics are ineffective, the primary care provider has the following
- Reevaluate and refer to
- Perform temporary
- Perform permanent
avulsion followed by chemical cautery (89% Phenol or 10% NaOH application -
3 applications maintained for 30 second intervals, alcohol dilution between
- Aftercare for all of the
above is continued soaks, daily tip cleaning and bandage application.
Indications for Specialty Care Referral
- After the reevaluation at
the end of the antibiotic period the primary care provider can refer the
patient to Podiatry for avulsion/surgical care if they do not feel
comfortable performing the procedure themselves. The patient should be
given a prescription for antibiotics renewal and orders to continue soaks
until avulsion can be performed.
- All Retiree's, VA and dependants with foot conditions
30, 31, 01, 02, 03, 04 etc.. Respectfully need to be routed to Scholfied Barracks Podiatry or net worked
out for treatment. Tripler Podiatry unfortunately does not provide orthotics or inserts for dependants,
VA or Retiree's.
Criteria for Return to Primary Care
- After completion of the
surgical procedure, patients will be returned to the primary care provider