Nail Surgery Flashcards
where is the nail matrix found?
extends over the base of the distal phalanx to the distal edge of the lunula
where is the nail bed found?
distal to the lunula
which part of the nail contributes to formation of the nail?
nail matrix, NOT the nail plate
the extension of the eponychium is called what?
cuticle
80% of the nail is produced by which part of the matrix?
proximal half of the matrix
what gives the convex appearance of the nail?
since nail activity is so much higher in the proximal portion, the nail is naturally curved in a convex shape from proximal to distal
what is the DuVries method for treating ingrown toe nails?
removing a large section of skin from the side of the toe to relieve soft tissue pressure on the side of the ingrown toenail
in a partial and total nail avulsion, is the nail matrix left intact or not?
matrix is left intact
what are the ways to perform partial matrixectomies?
- phenol & alcohol
- NaOH and acetic acid
- winograd
- Frost
- other matrix ablation techniques
which are the ways to perform total matrixectomies?
- phenol & alcohol (P&A)
- NaOH
- Zadik (Quenu)
- Whitney
- Kaplan
- Mini-kaplan
- terminal Syme
which are the ways to perform partial matrixectomies, NOT total matrixectomies?
Winograd & Frost
how does NaOH and acetic-acid help with ingrown toe nails?
same as P&A , NaOH helps destroy matrix and is neutralized by 5% acetic acid
what is the post-op care for P&A?
- apply dressing w/ silvadene
- keep dry and intact until next morning
- soak in warm water
- air dry
- avoid enclosed shoes for 1 week
describe the winograd procedure.
-wedge of skin and nail plate removed down thru matrix to bone with scalpel
when would you need to use the winograd procedure?
for patients with chronic ingrown toenail or with hypertrophied nail border
Describe the Frost procedure.
“L” shaped - one longitudinal incision thru nail plate extending from tip to skin proximal to nail plate; second incision at right angle to first extending away from nail plate at base of first incision
Describe the Zadik (Quenu) procedure.
H-shaped incision made with conecting incision placed proximal to eponychium
Which is the L-shaped incision?
Frost
What is the H-shpaed incision?
Zadik (Quenu)
which is the Whitney technique?
acisional technique that removes nail plate
What is the Kaplan technique?
cuts the nail bed right of the bone as well as huge sections of tissue on the side…may as well as amputate the toe
what is the terminal syme procedure?
removal of nail plate and matrix down to bone with circumferential incision around nail plate
how long should your applications of P&A be?
for partial matrixectomies- do 3 30-second applications
for total - do three 45-sec apps
Name 3 procedures that involve rasping bone.
Frost
Winograd
Mini-Kaplan
in P&A procedure, which acts as the “rinse”? which destroys the nail matrix?
phenol- destroys matrix
alcohol - acts as the rinse
in NaOH and acetic acid, which acts as the “rinse”? which destroys the matrix?
NaOH- destroys matrix
acetic acid- is the rinse
Which is the acisional procedure for removing matrix?
Whitney technique
