POSTOPERATIVE CARE
Proper dressings can reduce postoperative pain and throbbing and minimize complications. The dressing should be nonadherent, absorbent, and perfectly fitted so it remains in place. Applying large amounts of ointment (possibly containing antiseptics) covered with a nonadherent dressing such as petrolatum-impregnated gauze (e.g. Vaseline™ gauze,
Tulle gras, Adaptic®), or with added antiseptics (e.g. Xeroform™ gauze, Bactigras®, Betadine Tulle®), will protect the wound from drying and will allow an easy and painless removal. If postoperative bleeding is noticed, a bulky dressing made of two or three loose layers of mesh gauze will absorb bleeding and provide protection against trauma. A bandage or tube gauze such as Xspan® secures the dressing in place. Given the likelihood of postoperative edema, the dressing should not be too constrictive.
Postoperative pain management relies on two major interventions: elevation of the limb for 48 hours and analgesics. The latter should be adapted to the expected pain from the surgery. Acetaminophen and/ or nonsteroidal anti-inflammatory drugs (NSAIDs) are usually enough, but for some painful procedures, narcotic analgesics are sometimes prescribed. Keeping the limb elevated will minimize throbbing. Bleeding into the dressing can result in the bandage sticking to the surgical site. If this occurs, soaking the bandage will loosen it prior to its removal. Written instructions on how to perform postoperative care at home are highly recommended. Patients should also be informed about long-term paresthesias, especially at the digit tip, that can follow nail surgery and may last up to six months.