Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd
Upload
3 views

henderson1984

The document discusses the use of 'Superglue' as a temporary dressing for nail bed injuries, allowing for painless healing while the nail itself serves as a splint. A case report of a 50-year-old woman illustrates the successful application of this technique following nail bed surgery, resulting in normal nail regrowth after four months. The author advocates for retaining the nail as a dressing to minimize pain and facilitate healing.

Uploaded by

dr.mvillasana
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
3 views

henderson1984

The document discusses the use of 'Superglue' as a temporary dressing for nail bed injuries, allowing for painless healing while the nail itself serves as a splint. A case report of a 50-year-old woman illustrates the successful application of this technique following nail bed surgery, resulting in normal nail regrowth after four months. The author advocates for retaining the nail as a dressing to minimize pain and facilitate healing.

Uploaded by

dr.mvillasana
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

The Best Dressing For A Nail Bed Is The Nail Itself

H. P. HENDERSON
From the Leicester Royal Infirmary

The replacement of a surgically avuised nail as a splint and dressing with "Superglue" is
reported. It provides a painless cover for the sterile matrix and facilitates the dressing of finger
tip injuries.

In the past decade Plastic Surgeons have begun to use


cyanoacrylate glues for the attachment of skin grafts to
the margins of the recipient site and the fixation of
rubber bands to the nails of fingers requiring dynamic
traction following tendon repair. This "Superglue" can
also be used for fixing the fingernail over the sterile
matrix as a temporary and pain free dressing after nail
bed surgery. A small quantity of "Superglue" is placed
in the lateral nail bed gutter, which will fix the nail for
four to five days securely. During this time the nail bed
will heal spontaneously beneath the nail, which then
separates painlessly and can be discarded.

Case Report
A fifty year old healthy Caucasian lady presented with
distortion of the nail of the middle finger of one hand.
A bluish discolouration was noted through the buckled
nail at the level of the lunula and beneath the nail fold Figs. l - 3 T h r e e views o f t h e n a i l , with d i s t o r t i o n at t h e level o f t h e
close to the germinal matrix (Figs. 1-3). Under a digital lunula.
block with tourniquet, a proximally based skin flap was
raised off the base of the nail. The whole nail was
removed intact. A cyst was seen under the nail bed and a Subsequent follow-up showed that the nail had begun to
transverse incision was made across the central dome of re-grow normally and the appearance at two months is
it at the level of the base of the nail (Fig. 4). The cyst shown in Fig. 8. A completely normal nail was seen four
was removed intact, leaving a large cavity (Fig. 5). It months post-operatively (Fig. 9).
was thought that the germinal matrix may have been
damaged or distorted by the cyst or its surgical removal
and the incision line was repaired with a 6/0 prolene
suture, woven in a subcuticular fashion from one side of
the finger to the other (Fig. 6). The skin flap was re-
sutured in place, but the nail bed still presented a
slightly uneven surface and it was felt that the best
dressing would be the nail itself. The nail had become
Discussion
buckled by the cyst, as shown in Figs. 2 and 3, and by
scoring the under surface it was possible to flatten it so Replacing the nail as a splint and dressing in finger tip
that it would adapt to the flattened nail bed. The nail injuries was first brought to my attention by Dr. Guy
was then trimmed at its margins and its proximal part Foucher in Strasbourg, and I have found this a very
slipped beneath the edge of the skin flap. Some useful technique on several occasions since then. The
"Superglue" was then applied around the margin of the nail can be difficult to pass stitches through and for this
nail, thereby fixing it in place without the use of any reason is seldom used as a dressing in the treatment of
stitches (Fig. 7). The patient returned one week later and nail bed injuries or lacerated nails. I believe, however,
reported the nail had loosened that day. The prolene that the nail should be retained whenever possible
suture was removed. The nail bed had healed well and because it can be used as a splint and simultaneous
the patient commented that she had suffered practically waterproof dressing in many finger tip injuries, and in
no pain at all. A simple Bandaid dressing had been many cases eliminates most of the pain attributable to
applied to the finger tip at the time of the operation and exposure of the nail bed. A few drops of "Superglue"
this had been changed only once, and without difficulty. around the margin of the nail is sufficient to keep it in
place for long enough to provide time for adequate
Received for publication October, 1983.
H. P. Henderson, F.R.C.S., Leicester Royal Infirmary, Leicester LEI 5WW. healing of the underlying tissues.

VOL. 9-B No. 2 JUNE 1984 197


H.P. HENDERSON

Fig. 4 Transverse incision in the nail bed. Fig. 5 Cyst removed intact. Fig. 6 Subcuticular type suture across defect.

Fig. 7 Nail replaced and fixed with Superglue. Fig. 8 Nail after two months. Fig. 9 Nail after four months.

198 THE JOURNAL OF HAND SURGERY

You might also like