ABSTRACT
This chapter examines how a surgeon may treat a patient with recurrent infections of an ingrowing toenail. In the first instance, and in the presence of infection, a simple avulsion of the toenail may resolve the infection. A new nail will grow back, and in 20–30% of cases it does not develop any further infection. If the ingrowing nail recurs, wedge excision of one or both borders of the nail may be successful. This involves resection of the lateral part of the nail along with the associated nailbed. The contraindications for Zadek's procedure are, peripheral vascular disease and sepsis. The chapter examines how a surgeon performs Zadek's procedure. In Zadek's procedure the patient is consented and it is clearly explained to them that the toenail will never grow back. A local digital block is infiltrated around the base of the great toe and the area is cleansed and draped.
