Nail Bed Repair Technique

Nail bed repair.

Nail bed repair technique.

Wong would do differently the next time she tackles a similar repair all in under five minutes. They review the medical management suture technique and post ed care including things dr. 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. Nail bed repair see techniques nail bed lacerations.

1 there is controversy about how to repair nail bed lacerations. A hand surgeon was consulted to aid in repair of this complex injury. In this second segment we ll further delve in to some of the evidence and novel techniques regarding management of nail bed injuries. 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.

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. 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. This technique is. Nail bed repair repairing a nail bed injury will differ depending on the type of.

If this area scars down a new nail will not grow. In this brief video resident kelly wong and attending nick musisca demonstrate and discuss the appropriate management of nail bed lacerations. Treatment nail removal with d i nail bed repair. Tetanus and antibiotic prophylaxis.

However current evidence and. Good outcome depends on maintaining the space under the cuticle where the new nail will grow out from the germinal matrix. Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated. 1 if a distal phalanx fracture is present there is a 95 chance of a nail bed laceration.

Suture the nail bed if a large subungual hematoma is associated with an unstable or avulsed nail. Not every nail bed laceration requires nail removal and repair. 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.