From the Guidelines
The procedure to release pus from the base of a fingernail with a blade or needle is called a paronychia drainage or paronychia incision and drainage. This minor surgical procedure involves making a small incision at the site of infection to allow accumulated pus to drain from the infected tissue surrounding the nail. The healthcare provider will first clean and numb the area with a local anesthetic before using a sterile scalpel blade or needle to create a small opening where the pus has collected. After drainage, the area is typically cleaned with antiseptic solution and may be packed with sterile gauze if the abscess cavity is large. Following the procedure, patients should keep the area clean and dry, elevate the affected finger when possible, and take prescribed antibiotics if indicated. Warm water soaks for 15 minutes 3-4 times daily can help with healing. This procedure is necessary because paronychia infections create pressure as pus accumulates, causing pain and potentially spreading infection. Drainage provides immediate pain relief by releasing this pressure and allows the infection to heal more quickly by removing the collected bacteria and inflammatory cells.
Key Considerations
- The decision to perform incision and drainage should be based on the presence of purulent material and the clinical judgment of the healthcare provider 1.
- The use of antibiotics should be reserved for cases with significant systemic signs of infection, such as erythema and induration extending >5 cm from the wound edge, temperature >38.5°C, heart rate >110 beats/minute, or white blood cell (WBC) count >12 000/µL 1.
- The choice of antibiotic should be guided by the suspected or confirmed causative organism, with consideration of the patient's underlying health status and potential allergies 1.
Post-Procedure Care
- Patients should be instructed to keep the area clean and dry, and to elevate the affected finger when possible.
- Warm water soaks for 15 minutes 3-4 times daily can help with healing.
- Patients should be monitored for signs of infection, such as increased redness, swelling, or purulent discharge, and should seek medical attention if these symptoms occur.
The most recent and highest quality study supporting this recommendation is the 2014 update by the Infectious Diseases Society of America 1, which provides guidance on the diagnosis and management of skin and soft tissue infections, including paronychia.
From the Research
Procedure for Releasing Pus from the Base of a Fingernail
- The procedure to release pus from the base of a fingernail with a blade or needle is not explicitly mentioned in the provided studies.
- However, the studies discuss the management of abscesses, which are localized collections of purulent material surrounded by inflammation and granulation in response to an infectious source 2, 3, 4.
- Incision and drainage (I&D) is a common procedure used to treat abscesses, which involves making a surgically appropriate incision to allow adequate drainage without injuring important structures 3, 4.
- The use of a blade or needle to release pus from the base of a fingernail may be considered a form of I&D, but it is not specifically mentioned in the provided studies.
- It is worth noting that the management of abscesses, including those located at specific sites such as the fingernail, may require special consideration and may involve different treatment approaches 3, 4.