Toenail Ablation / Zadek’s Procedure

The Operation

Partial nail avulsion

Partial nail avulsion, where part of the toenail is removed, is the most common surgical procedure for treating ingrown toenails.

It is carried out under local anaesthetic, which is injected into the base of your toe on either side. The edges of your toenail are cut away to make the toenail narrower and give your nail a straight edge. This makes it†less likely to dig into the surrounding skin.

After the edges of the toenail have been cut, a chemical called phenol is applied to the affected area to prevent any nail growing back and causing an ingrown toenail to develop in the future. Sometimes, a surgical method is used (Zadek procedure), where a small incision is made in the skin at the corner of the nail. The root of the nail is removed with a blade. The wound is then closed with a dissolvable stitch.

During the procedure, any pus that is present in the affected area will be drained away from the toe to prevent the area becoming more infected

Total nail avulsion

To reduce the risk of an ingrown toenail developing in the future, your whole toenail may be removed. This procedure is known as a total nail avulsion.

Total nail avulsion may be recommended if your nail is thickening and pressing into the skin surrounding your toe. As with partial nail avulsion, this is also carried out using local anaesthetic.

During the procedure, the nail will be removed and you will be left with the indentation (the†concave area of skin) where your toenail used to be. It is perfectly safe to not have a toenail and your toe will continue to function normally.