Post-Operative Toenail Removal Care Instructions
After toenail removal, proper wound care is essential to prevent infection, reduce pain, and promote optimal healing. The following instructions will guide you through the post-operative care process.
Immediate Post-Operative Care (First 48-72 Hours)
- Keep the original dressing in place for 24-48 hours unless instructed otherwise by your healthcare provider 1
- Elevate the foot above heart level as much as possible to reduce swelling and pain
- Take pain medication as prescribed or use over-the-counter pain relievers as recommended
- Limit weight-bearing and walking on the affected foot initially 1
- Monitor for signs of infection including increased pain, redness extending beyond the toe, warmth, swelling, or discharge 1
Wound Care After Initial Dressing Removal
- Gently clean the area daily with lukewarm water (avoid hot water)
- Do not soak the foot in a footbath as this can induce skin maceration 2
- Apply recommended topical treatments such as povidone-iodine 2% twice daily if prescribed 1
- Apply a thin layer of petroleum jelly around the nail edges for lubrication 1
- Cover with a clean, dry dressing after cleaning and applying medication
- Change the dressing daily or more frequently if it becomes wet or soiled
Infection Prevention
- Wash hands thoroughly before and after wound care
- Keep the area clean and dry
- Avoid trauma to the affected area 1
- Do not remove any drainage tubes or packing if present, unless instructed by your healthcare provider
- Apply topical antibiotics if prescribed for preventing infection 1
Activity Guidelines
- Limit standing and walking for the first few days 2
- Gradually increase activity as pain and swelling decrease
- Avoid strenuous activities that may cause trauma to the toe for 2-3 weeks
- Wear open-toed shoes or sandals until healing is complete to avoid pressure on the wound
Follow-Up Care
- Return for follow-up within 48-72 hours if there are signs of infection 1
- Otherwise, follow up in 1-2 weeks to ensure proper healing 1
- Contact your healthcare provider immediately if you notice:
- Increasing pain not relieved by medication
- Spreading redness beyond the toe
- Pus or foul-smelling discharge
- Fever above 100.4°F (38°C)
- Bleeding that doesn't stop with gentle pressure
Long-Term Prevention
- Trim toenails straight across (not rounded at the corners) 1, 3
- Keep feet clean and dry
- Wear properly fitting shoes with adequate toe box 1
- Apply emollients to cuticles and periungual tissues daily to prevent dryness and cracking 1
- Avoid tight socks or hosiery that compress the toes
Special Considerations
- For diabetic patients: More vigilant monitoring is required due to increased infection risk; contact your provider at the first sign of any complications 1
- For patients with poor circulation: Keep feet warm, avoid injury, and monitor closely for healing progress
When to Seek Medical Attention
- Increased pain, swelling, or redness that extends beyond the immediate area
- Drainage of pus or foul-smelling discharge
- Fever or chills
- Bleeding that doesn't stop with gentle pressure
- Failure of the wound to show signs of healing after 1-2 weeks
Following these instructions carefully will help ensure proper healing and reduce the risk of complications after toenail removal. The evidence suggests that keeping the wound clean and dry, rather than using footbaths, leads to better outcomes 2, 4.