Preventing and Managing Complications of Nail Surgery

In a presentation on the complications and management of nail surgery, Dr. Morrison emphasizes the importance of preventing issues such as digital ischemia by ensuring tourniquets are removed post-surgery. He shares data from 339 procedures, noting low infection rates, particularly after avulsions, and highlights the prevalence of post-operative pain, advising clinicians to set realistic expectations for patients and to consider using long-acting anesthetics for pain management. He discusses the minimal but identifiable complications such as infections, often caused by pseudomonas, and scarring, which can occur depending on the procedure performed. To mitigate these risks, he advocates for minimizing trauma to the nail unit and implementing protective bandaging strategies to maintain function and promote healing. He also cautions against excessive bandaging, which can lead to stiffness and hinder digit use. Finally, Morrison encourages proper wound care, including the potential use of prophylactic antibiotics in certain cases, and stresses the importance of educating patients about post-operative care and the signs of complications.