Partial Medial Aspect Permanent Removal of Left First Toenail

Pre-Procedure Preparation

Ensure proper sterilization of the surgical field and administer appropriate local anesthesia, as recommended by the Infectious Diseases Society of America, to prevent infection in patients undergoing partial nail removal 1

Apply appropriate wound dressings based on the wound characteristics, such as dry or exudative wounds, as suggested by the Infectious Diseases Society of America, to promote healing and prevent infection 2
Instruct the patient on proper foot hygiene and wound care, as recommended by the Infectious Diseases Society of America, to prevent infection and promote healing 1

Assess for signs of infection or poor circulation before proceeding with partial nail removal, as recommended by the Infectious Diseases Society of America, to prevent complications in diabetic patients 1
Be vigilant for signs of infection post-procedure, as diabetic patients have a higher risk of complications, and consider consultation with a vascular specialist if there are signs of ischemia, as suggested by the British Association of Dermatologists 3

Consider treating the fungal infection before or concurrently with the partial nail removal, as recommended by the British Association of Dermatologists, to prevent infection and promote healing 4, 3
Terbinafine is the preferred oral antifungal for diabetic patients with onychomycosis due to lower risk of drug interactions, as suggested by the British Association of Dermatologists 3

Laser ablation of the nail matrix is an alternative to electrocauterization, but with less evidence supporting its use, as reported by the British Association of Dermatologists 5