They review the medical management suture technique and post ed care including things dr.
Nail bed repair technique.
There are also nail bed injuries that affect more than your nail bed such as a fingertip fracture or amputation.
Good outcome depends on maintaining the space under the cuticle where the new nail will grow out from the germinal matrix.
A hand surgeon was consulted to aid in repair of this complex injury.
If this area scars down a new nail will not grow.
Laceration of the nail and underlying nail bed usually present with the nail intact and a subungual hematoma greater than 50 of nail surface area.
In part i of this post i gave an example of a nail bed laceration that was closed in my ed using fairly traditional methods and teaching.
This technique is.
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If a subungual hematoma involves more than half the nail plate there is a 60 chance of a nail bed laceration and a high likelihood of fracture.
If the nail plate is unavailable or too badly damaged for a portion of it to be replaced see the image below a nail shaped sheet of reinforced silicone or a sterile petroleum gauze may be placed as a sterile dressing within the nail fold as a substitute after nail bed repair.
In this second segment we ll further delve in to some of the evidence and novel techniques regarding management of nail bed injuries.
Suture the nail bed if a large subungual hematoma is associated with an unstable or avulsed nail.
Wong would do differently the next time she tackles a similar repair all in under five minutes.
Tetanus and antibiotic prophylaxis.
Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated.
In this brief video resident kelly wong and attending nick musisca demonstrate and discuss the appropriate management of nail bed lacerations.
Nail bed repair.
Treatment nail removal with d i nail bed repair.
Nail bed repair see techniques nail bed lacerations.
Nail bed repair repairing a nail bed injury will differ depending on the type of.
Not every nail bed laceration requires nail removal and repair.
If the nail is firmly adherent and disruption of surrounding tissue is minimal there is likely to be a good cosmetic outcome without primary nail bed repair.
However current evidence and.