Nail Bed Repair Technique

If a subungual hematoma involves more than half the nail plate there is a 60 chance of a nail bed laceration and a high likelihood of fracture.

Nail bed repair technique.

Just because a nail bed laceration is present it doesn t mean nail removal with obligate repair is indicated. A hand surgeon was consulted to aid in repair of this complex injury. If the nail is firmly adherent and disruption of surrounding tissue is minimal there is likely to be a good cosmetic outcome without primary nail bed repair. Laceration of the nail and underlying nail bed usually present with the nail intact and a subungual hematoma greater than 50 of nail surface area.

Nail bed repair. Nail bed repair repairing a nail bed injury will differ depending on the type of. 1 there is controversy about how to repair nail bed lacerations. Good outcome depends on maintaining the space under the cuticle where the new nail will grow out from the germinal matrix.

There are also nail bed injuries that affect more than your nail bed such as a fingertip fracture or amputation. 1 if a distal phalanx fracture is present there is a 95 chance of a nail bed laceration. In this second segment we ll further delve in to some of the evidence and novel techniques regarding management of nail bed injuries. In the presence of a subungual hematoma of at least 50 percent they recommend removal of the nail with exploration for nail bed laceration and if found primary repair.

If the nail plate is unavailable or too badly damaged for a portion of it to be replaced see the image below a nail shaped sheet of reinforced silicone or a sterile petroleum gauze may be placed as a sterile dressing within the nail fold as a substitute after nail bed repair. However current evidence and. Suture the nail bed if a large subungual hematoma is associated with an unstable or avulsed nail. Tetanus and antibiotic prophylaxis.

Not every nail bed laceration requires nail removal and repair. In part i of this post i gave an example of a nail bed laceration that was closed in my ed using fairly traditional methods and teaching. If this area scars down a new nail will not grow. This technique is.

In this brief video resident kelly wong and attending nick musisca demonstrate and discuss the appropriate management of nail bed lacerations. Nail bed repair see techniques nail bed lacerations. Treatment nail removal with d i nail bed repair.