Fingernail or Toenail Removal in Children

Fingernail or Toenail Removal in Children

An injury, accident, or medical condition may require your child’s health care provider to remove the nail on a finger or toe. Removal of a nail may be necessary when the nail is ingrown, infected, or damaged, or when it has not grown properly.

Tell a health care provider about:

  • Any allergies your child has.
  • All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems your child or family members have had with anesthetic medicines.
  • Any blood disorders your child has.
  • Any surgeries your child has had.
  • Any medical conditions your child has.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Pain.
  • Bleeding.
  • Infection.
  • The nail growing back improperly.
  • Allergic reactions to medicines.

What happens before the procedure?

  • Ask your child’s health care provider about:
    • Changing or stopping your child’s regular medicines. This is especially important if your child is taking diabetes medicines or blood thinners.
    • Giving over-the-counter medicines, vitamins, herbs, and supplements.
    • Giving medicines such as aspirin and ibuprofen. These medicines can thin your child’s blood. Do notgive your child these medicines unless your child’s health care provider tells you to give them.
  • Follow instructions from your child’s health care provider about eating or drinking restrictions.

What happens during the procedure?

  • To lower your child’s risk of infection:
    • Your child’s health care team will wash or sanitize their hands.
    • Your child’s skin will be washed with soap.
  • An IV may be inserted into one of your child’s veins.
  • Your child may be given one or more of the following:
    • A medicine that helps your child relax (sedative).
    • A medicine that numbs the area (local anesthetic).
  • An instrument will be inserted underneath the nail to lift it up.
  • A cut (incision) may be made in the nail.
  • The nail will be removed.
  • A bandage (dressing) will be put over the area where the nail was removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines he or she was given have worn off.
  • If your child had a fingernail removed, he or she may be given a finger splint to wear while he or she recovers.
  • If your child had a toenail removed, he or she may be given a surgical shoe to wear while he or she recovers.
  • Your child may need to keep his or her finger or toe raised (elevated) or supported on a pillow for 24 hours or as told by your child’s health care provider.

Summary

  • Removal of a nail may be necessary when the nail is ingrown, infected, or damaged, or when it has not grown properly.
  • Before the procedure, tell a health care provider about all medicines your child is taking and any medical conditions he or she has.
  • Your child will be given medicine to numb the area, and the nail will be removed.
  • After a fingernail is removed, your child may be given a finger splint to wear while he or she recovers.
  • After a toenail is removed, your child may be given a surgical shoe to wear while he or she recovers.

Fingernail or Toenail Removal, Pediatric, Care After

This sheet gives you information about how to care for your child after the procedure. Your child’s health care provider may also give you more specific instructions. If you have problems or questions, contact your child’s health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Pain.
  • Redness.
  • Swelling.
  • Soreness.

Follow these instructions at home:

If your child has a splint:

  • Do notallow your child to put pressure on any part of the splint until it is fully hardened. This may take several hours.
  • Have your child wear the splint as told by your child’s health care provider. Remove it only as told by your child’s health care provider.
  • Loosen the splint if your child’s fingers or toes tingle, become numb, or turn cold, pale, or blue.
  • Keep the splint clean.
  • If the splint is not waterproof:
    • Do notlet it get wet.
    • Cover it with a watertight covering when your child takes a bath or a shower.

Wound care

  • Follow instructions from your child’s health care provider about how to take care of the wound. Make sure you:
    • Wash your hands with soap and water before you change your child’s bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your child’s dressing as told by your child’s health care provider.
    • Keep your child’s dressing dry until your health care provider says it can be removed.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your child’s health care provider tells you to do that.

Check your child’s wound every day for signs of infection. Check for:

  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

  • Have your child gently move his or her fingers or toes often to avoid stiffness and to lessen swelling.
  • Have your child raise (elevate) the injured area above the level of his or her heart while he or she is sitting or lying down. Your child may need to keep the finger or toe raised or supported on a pillow for 24 hours or as told by your child’s health care provider.
  • Have your child soak his or her hand or foot in warm, soapy water for 10–20 minutes, 3 times a day or as told by your child’s health care provider.

Medicine

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • If your child was prescribed an antibiotic medicine, give or apply it as told by your child’s health care provider. Do not stop using the antibiotic even if your child’s condition improves.

General instructions

  • If your child was given a shoe to wear, have your child wear it as told by your child’s health care provider.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child has increased pain or swelling after the procedure.
  • There is fluid coming from your child’s nail area that is green or yellow or smells bad.

Get help right away if:

  • There is more redness, swelling, or pain around your child’s wound.
  • There is more fluid or blood coming from your child’s wound.
  • Your child’s wound feels warm to the touch.
  • There is pus or a bad smell coming from your child’s wound.
  • Your child has a fever.
  • Your child’s finger or toe looks pale, blue, or black.

Summary

  • After the procedure, it is common to have pain and swelling.
  • Have your child keep the finger or toe raised (elevated) or supported on a pillow as told by your child’s health care provider.
  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Check your child’s wound every day for signs of infection.
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