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Hi, Ive only done 4 phenol procedures since graduated and only the last one I had no other podiatrist around as backup/help.

Just wanted some feedback from those very expericed in this procedure.

In your normal healthy case what are your post op care, expectations of appearance after a week/month and then onst complete healing has taken place? also in my current case redness at the base of the nail- from the phenol is still apparent and how long can this last? In this case she also has 2 blood blisters at the base of the nail. She is a highschool teacher and says a few students have stepped on her feet! Should I be worried. She doesnt have much tenderness unless a lot of pressure is placed on the areas and should there be some tenderness till complete healing?

I tell patients not to touch dressings and keep dry for first 3 days. There after can have normal showers. Salt baths and dress with bactigrass, melomite, gauze and tubegauze. I see them twice a week for the first month and a half and they change dressings regularly.

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Jo jo

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I wouldn't advise Do you have someone to assist you during nail surgery? I always do the procedure in 2's as you never know when a patient may have complications i.e anaphylaxis shock!

Regarding post op. I dress the toe the next day & then 1 wk, 2wk & 4wk,4wk then discharge. If there is infection or problems then this changes. If the patient has blood blisters, you mentioned trauma to the nail bed so i wouldn't be too concerned. Check her footwear as this could be causing trauma too.

Redness around the PNF can take a while to settle it depends if the redness is from trauma or a phenol burn etc. Just ensure the patient is doing saline baths and dressing appropriately and obviously check for the S&S of infection.

Hope this helps

Hi Jojo

You will get many different protocols from different pods, we all have variations, no one is right or wrong if the outcome is satisfactory!

Phenol flare is common, and I have had blistering with phenol burns also, normally this presents no problem and the tissue heals without intervention.

I see patients next day post op, 1 week, 2 week and again about 4 to 6 weeks if all is well, they can always ring if there is a problem. I allow them to shower and redress wound with dry dressing themselves after day 2. I dropped saline baths a few years ago as there seems to be no real advantage to it( cannot remember the paper but it was in Pod Now) and healing times have been reduced in my patients as a result of this. The area can remain tender for some weeks post op with
pressure, so shoe wear needs to be appropriate!

I always explain to the patient that the toe will look worse before it looks better and reassure them that infection is extremely unlikely .

Good luck, the more you do the less you will worry!

ps I do nail surgery solo but I am in aGP surgery so there is back up if needed.

Regards
CM

Hello. Does anyone know what the latest recommendation is Phenolisation time for nail surgery? I.e 3x 30 seconds. There seems to be a range of times podiatrists use e.g. anything from 3x 10 seconds to 3x 60 seconds. I am writing up a nail surgery policy and would like to use recommended best practice.

Thank you.
Mimmypod