Whether you have suffered a sports injury or a minor domestic accident, a toenail laceration is a painful event. Doctors speak of avulsion when the nail completely detaches from its place (nail bed). Thankfully, many of these wounds can be treated at home with proper cleaning and dressing procedures, as long as you are able to recognize the signs that indicate when it is best to seek medical attention.
Steps
Part 1 of 3: Treating the Laceration at Home
Step 1. Manage what's left of the nail
Some avulsions are considered minor - most of the nail remains attached - while others involve complete detachment. After the accident, it is necessary to take care of the remaining stump properly, in order to start the healing process on the "right foot". Leave everything attached that has not separated from the finger; if a portion of the nail has detached from its place, cut it off gently, trying to get as close as possible to the cuticle or the contact area. Cut along the line of the tear.
- File the stump so that the edge is smooth to prevent it from getting stuck in the fibers of the socks or sheets.
- If you are impressed by the sight of the laceration or are having difficulty, ask a friend or family member to help you. children probably need the intervention of an adult.
- If you wear toe rings, remove them before treating the wound. If you have trouble getting your jewelry off, you can use soap and water to lubricate your skin; if you can't, call your doctor.
Step 2. Stop any bleeding
Apply direct pressure to the wound site using a clean cloth or gauze and hold it in place for 10 minutes or until the bleeding stops. to help the process, lie down and lift your foot up on pillows.
If the bleeding does not stop after 15 minutes, see your doctor
Step 3. Thoroughly clean the wound
Wash your finger with warm soapy water and a cloth. If the area is dirty, gently scrub away the debris, taking care to also remove any dried blood and other debris. don't be afraid to ask a friend or relative for help. Clean the area as best you can to avoid possible infections.
Dry your foot and finger by dabbing with a clean cloth or towel; avoid rubbing, otherwise you may stimulate the bleeding to resume
Step 4. Apply antibiotic ointment
Once your finger is clean and dry, smear a trivalent antibiotic ointment on the wound, which you can typically buy at a pharmacy without a prescription.
- You can find the drug in the form of a cream, but you should still opt for the ointment, which prevents the gauze from sticking to the lesion.
- If the skin is intact and there are no cuts or scrapes, you can just use petroleum jelly instead of the antibiotic product.
Step 5. Put on a bandage
Purchase sterile gauze or non-stick bandages and medical tape. Apply the gauze to the injured finger (cutting it to fit the size if necessary) and then wrap it several times with a bandage to keep it in place. Let a generous portion of the dressing protrude beyond your finger, so that you can gently fold it over the nail and create a sort of "hood" that you can easily remove later. Secure everything with two strips of medical tape arranged in an X, to allow the dressing to adhere to the foot and remain in place.
- You can purchase non-stick gauze or be sure to smear petroleum jelly or ointment on the wound before bandaging your finger. When you remove the bandage, be very careful not to jerk the nail or the injured area; if the gauze sticks to the lesion, soak the foot in hot water for a few minutes to help it detach.
- Do not bandage your finger so tightly that it turns red, purple, or to the point of losing tactile sensitivity; the dressing should be firm but not constricting.
Step 6. Change the bandage every day
Take it off gently daily and wash your finger with hot soapy water; apply the antibiotic ointment again and put on a new gauze. If the bandage gets dirty or wet, replace it. You should stick to this regimen for 7-10 days, until the nail bed (the soft, sensitive part under the nail) becomes hard.
Ideally, you should put on a new, clean bandage every night before bed. by doing so, you protect the injured nail from bumps or tugs while you sleep
Part 2 of 3: Minimizing the Pain
Step 1. Apply ice often during the first day
In the first 24 hours after the accident, place the ice pack on the wound for 20 minutes every two hours to control swelling and pain. Fill a plastic bag with ice and wrap it in a towel before putting it on your foot to avoid direct contact with an object that is too cold.
After the first day, continue cold therapy for 20 minutes 3-4 times a day
Step 2. Lift your foot
If you experience throbbing pain, lie down and place your injured foot on top of some pillows so that it is higher than your heart. This is a small step to help reduce swelling; do this for the first 48 hours.
Step 3. Take over-the-counter pain relievers
Ibuprofen and naproxen keep edema in check and help you manage pain; acetaminophen is ineffective on swelling, but it is a pain reliever. All medicines are available in pharmacies without a doctor's prescription, but scrupulously respect the dosage indicated on the leaflet.
If you have heart problems, kidney disease, hypertension, suffer or have suffered from a peptic ulcer, ask your doctor for advice before taking these drugs
Step 4. Wear comfortable or open-toed shoes for several weeks
Narrow footwear applies painful pressure to the injured nail, so opt for loose or pointy toes to reduce pain and promote healing. Respect this guideline for as long as you feel necessary.
Part 3 of 3: When to See Your Doctor
Step 1. Go to the doctor if there are any signs of infection
No matter how carefully you dealt with the injury, it could still become infected. If so, you may notice red streaks starting from the finger and extending to the foot or leg. you may also have a fever of 38 ° C or higher. Another sign of infection is the presence of pus - a thick, white or colored substance that comes out of the wound. If you notice any of these symptoms, go to the doctor's office, as it could be a serious complication.
If you have an infection, your doctor may prescribe antibiotics; take them as directed until you have finished your course of therapy
Step 2. See your doctor if the pain, swelling or redness gets worse
If the pain is severe enough to prevent you from sleeping or doing daily activities, does not subside within two hours of taking painkillers, or gets worse over time, you need professional intervention. If the swelling becomes more severe and doesn't improve with applying ice, taking medication, and lifting your foot, see your doctor.
Ask yourself questions about the intensity of the pain, for example: "The finger is more sore today than it was yesterday and ibuprofen does not improve the situation: is this normal?" or "What is the level of swelling considered normal?"
Step 3. Get examined if your nail turns black or blue
Sometimes, a toenail crush injury (such as a heavy object falling on the toes) causes a subungual hematoma - a pocket of blood that generates pain because it builds up pressure. It manifests itself as a blue, black or purple spot under the nail and, if it occupies less than ¼ of the nail surface, it probably disappears on its own; if not, you need to see your doctor, as drainage may be needed to avoid further damage and pain. Don't try to do it yourself or ask someone else to puncture the hematoma, but go to the doctor.
The doctor makes a small hole in the nail from which he lets the blood out; it should be a painless procedure and the drainage should give you relief, because it reduces the pressure under the nail
Step 4. Don't hesitate to call the doctor in case there is obvious damage surrounding the torn nail
Normal regrowth depends on whether the nail bed has been damaged or not. If you are concerned about what your nail may look like when it grows, consider having a minor surgery with your doctor. If the surrounding area is compromised, for example there are cuts, go to the doctor's office; if the nail bed and matrix are badly damaged, the new nail may not grow or have a different shape - but these are solvable problems.
It takes 6-12 months for the toenail to fully grow back
Step 5. Get help if you can't clean the wound
If you spend a quarter of an hour or more scrubbing your nail to clean it and with poor results, see your doctor. It is essential that the wound is thoroughly cleansed to avoid infections; if you can't do it yourself, someone should help you.
Depending on the dynamics of the accident, you may be given a tetanus booster injection or immunoglobulin injection. If the wound is dirty and it has been at least five years since the last booster, you need to inject, as well as if the cut is clean, but you have not been vaccinated for at least 10 years
Step 6. Take x-rays if your finger doesn't move or looks abnormal
Many injuries that cause nail avulsion are also responsible for fractures. Watch your finger to see if you can bend and straighten it completely; if not, take note if it is bent or facing unnaturally in one direction, as it may be broken. If this is your case, you need to go to the emergency room to get proper care.
