My Surgical Tips for Management of Ingrowing Nails

In this presentation, Dr. Martin Zia shares valuable surgical tips for managing ingrowing nails and performing nail matrix biopsies. He emphasizes the use of a double hinge nail clipper to minimize torque while cutting and the importance of soaking the nail to soften it before treatment, supplemented with chlorhexidine for disinfection. Dr. Zia discusses various methods for applying tourniquets, highlighting his preference for using a glove to facilitate hemostasis while maintaining sterility. He explains a diluted lidocaine solution for local anesthesia that enhances patient comfort during procedures. One of his key techniques involves lifting the nail plate for access to distal lesions and recommends marking the area to easily locate lesions during surgery. He describes two techniques—tangential nail matrix biopsy and the trapdoor technique—emphasizing careful incision, inflation of the matrix for easier removal of lesions, and securing the nail plate post-procedure with cyanoacrylate glue. His methods prioritize minimizing patient discomfort and preserving the aesthetics of the nail afterward, allowing for nail polish application post-surgery. Dr. Zia concludes by reinforcing the necessity of proper technique and orientation for specimens sent to pathology.