photos by Sydney Podiatric Surgeon Damien Lafferty

(This content is intended for healthcare professionals only)

Just a reminder of the importance of removing hypergranulation tissue during a partial nail avulsion with penalisation (PNA).

This young boy had this recalcitrant ingrown toenail for over a year (hence the length of the nail). His GP and podiatrist had attempted various options over the year including previous surgery; all unsuccessful.

The nail was obviously trimmed first and then the PNA was carried out. Please note the presence of the hypergranulation tissue pre-op and the complete absence of hypergranulation tissue post-op. I feel this is imperative to remove, to allow for a quick recovery and an excellent result. It can be trimmed with a simple 15 blade, curette or fine iris scissors. The skin can be reflected back and only the hypergranulation is trimmed, without the need for skin incisions.

If anyone would like me to show them how to carry this out, feel free to contact me.