Complications of an ingrown toenail

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A lovely 70 year old female presented with a toe infection on-going for a few days. She relates having an ingrown nail causing her pain and was subsequently removed by a podiatrist. 

She is a diabetic and admits to going back to work after the procedure. Several days later I was called to see her in the emergency room. See far left image. There was increasing redness, swelling and purulent material draining out the nail bed. Her prognosis was bleak. 

I didn't know if the toe could be saved but I told her I would try. I worried that if we did nothing, the infection would spread affecting other parts of her feet. So we wheeled her into surgery right away. 

Paying close attention to the blood source to the toe, an incision was made down the middle and the infection was gently cleared out with a curette. The wound remained open to allow further drainage. She was admitted to the hospital for IV antibiotics and debridement was performed daily until I was comfortable that the infection was controlled. 

Several weeks later, she is doing quite well. 

Complications of an ingrown nail is rare but the risk is still present, especially in patients with diabetes. It is important for patients to feel comfortable in addressing any problems they have after a procedure immediately with their doctor and equally important for the doctor or their medical assistant to be available as well. Don't take any procedures lightly and as you can see here, complications are real but if dealt with in a timely fashion, prognosis can be good.