From the Research
Management of Lacerations with Nail Involvement in Urgent Care
- Lacerations with nail involvement can be managed in urgent care, as studies have shown that emergency physicians can treat uncomplicated nail bed lacerations with no significant difference in outcomes compared to plastic surgeons 1.
- The management of simple nail bed lacerations and subungual hematomas in the emergency department is crucial to prevent long-term fingertip deformities and functional deficits 2.
- Nail bed injuries must be appropriately diagnosed and treated initially, as secondary repair is often unsatisfactory 3, 4.
- Appropriate management of acute fingertip and nail bed injuries is critical for optimizing patient outcomes, and mismanaged injuries can lead to chronic pain and deformity 5.
Treatment Options
- Simple nail bed lacerations may be repaired using dissolvable suture or octyl-2-cyanoacrylate, with no need to replace the nail plate or stent the fold 5.
- Subungual hematomas may be treated with simple trephination for pain relief 5.
- Amputations, partial or complete, can be treated with a wide variety of techniques, but many distal injuries can be left to heal by secondary intention with excellent results 5.