Ingrown toenail surgery is a common procedure performed to relieve the discomfort and infection caused when the edge of a nail grows into the surrounding skin. The most frequent surgical approach involves a partial nail avulsion, where the offending portion of the nail is removed. This is often followed by a chemical matrixectomy using an agent like phenol to prevent the nail segment from regrowing and causing a recurrence. Successfully healing after this procedure relies heavily on following a precise post-operative care regimen. Attention to the wound site, managing pain and swelling, and making necessary lifestyle adjustments are all important steps to ensure a smooth recovery and minimize complications.
Immediate Post-Operative Care
The first 24 to 48 hours following your procedure focus on initial stabilization and controlling acute symptoms. A bulky, sterile dressing is applied immediately after surgery to protect the wound and manage initial bleeding. It is advised not to remove or disturb this original dressing during this initial period unless instructed otherwise by your surgeon.
To significantly reduce swelling and throbbing pain, it is important to keep the foot elevated above the level of your heart as much as possible. This position uses gravity to help drain excess fluid from the surgical site, which promotes comfort and limits the pressure on the newly treated area. Mild discomfort is expected once the local anesthetic wears off, and this can typically be managed using over-the-counter pain relievers such as acetaminophen or ibuprofen, following medical instructions. Minor oozing of blood or a clear yellowish fluid is normal during the first day, but excessive bleeding that soaks through the dressing requires a call to your doctor.
Ongoing Wound Cleaning and Dressing Changes
Routine wound care typically begins 12 to 48 hours after the procedure, once the initial thick dressing is removed. A common method involves soaking the operated foot in warm water, which helps to loosen the initial bandage and gently clean the area. Some healthcare providers recommend adding Epsom salts to the warm water, as this can help soothe the tissue and reduce inflammation. Soaking is usually performed for about 15 to 20 minutes, often twice a day for the first week.
After each soak, the toe should be gently patted completely dry with a clean towel or gauze, as keeping the wound dry is important for preventing bacterial growth. If instructed, apply a small amount of antibiotic cream or ointment to the surgical site before putting on a fresh, sterile dressing. The dressing serves as a protective barrier against external contaminants and should be changed daily, or more often if it becomes wet or soiled. This routine of soaking, drying, and redressing is necessary for one to two weeks, or until the wound is no longer draining and the skin has closed.
Activity Limitations and Footwear Selection
Physical activity must be significantly limited in the days immediately following the surgery to ensure the tissue heals without disruption. While you may be able to walk immediately after the procedure, movement should be kept to a minimum for the first couple of days to avoid putting undue pressure on the wound. Returning to normal daily activities can often happen within a few days to a week, but more strenuous activities like running, jumping, or intense exercise should be avoided for a longer period, generally two to three weeks.
The choice of footwear is a practical consideration that directly affects the recovery process. For up to two weeks post-surgery, wearing open-toed shoes, sandals, or a loose-fitting post-operative boot is strongly recommended. This prevents any external pressure or rubbing against the surgical site, which could cause pain, bleeding, or disrupt the healing process. Tight socks or closed-toe shoes with a narrow toe box must be avoided until the toe is fully healed, as they can compress the toe and contribute to the risk of the nail becoming ingrown again in the future.
Recognizing Signs of Potential Complications
While most recoveries proceed smoothly, it is important to know the signs that may indicate a complication, most commonly an infection. Expected post-operative pain should gradually decrease each day, so persistent or worsening pain that does not improve with medication is a warning sign. Similarly, some initial swelling is normal, but if the redness and swelling begin to spread away from the incision site or the area feels increasingly warm to the touch, this may signal a developing infection.
A small amount of clear or pink-tinged drainage is typically seen, but the appearance of thick, opaque, yellow, or green pus, especially if accompanied by a foul odor, is a clear indication of a problem. Systemic symptoms, such as a fever or chills, suggest the infection may be spreading beyond the toe and require immediate medical attention. If any of these concerning signs appear, or if you experience excessive bleeding that continues after the first day, contact your surgical team promptly for an assessment.