And, Action! today we’re here with Dr. Martin
we’re helping him out he’s had a little injury so we’re
gonna go ahead and proceed with another partial nail avulsion I’d like for you guys
come close we have an ingrown nail also known as a paronychia he has developed this pyogenic granuloma once again it’s a hyper-granulation piece of
tissue as a result of the ingrown nail the body actually creates that alone and
and I can rest assure that there is a very large piece of nail in
there and we’re gonna go ahead and we’re going to take this amount of the nail
out to make sure that this does not occur again it is very important these are very uncomfortable
what we’re gonna do first is we’ll just kind of lift everything up just check on
the patient is everything okay if feel any discomfort just please let us
know I’ll take our English anvil there’s other
podiatrists that will use other techniques there’s a couple of different
techniques just to get all the way back there but we have to be very, very
careful with the nail root go underneath the pyogenic granuloma this is a very large nail so basically
what we’ve done is this piece of nail as everyone can see this is
all the way back all the way back underneath the the proximal nail fold I’m gonna go ahead and check to make
sure four-by-four and the english anvil
again please sorry about that, sir we cannot leave any pieces behind if we’d leave any pieces behind
that’s not gonna be a good thing so now we’re gonna go to
the second part of the procedure as everyone can tell we have
this flap of skin of red tissue which is the pyogenic granuloma we can use this we can use a blade and I’m just going to show you guys here it’s kind of attached we’re not going to take a whole lot we’ll start from here
these pyogenic granulomas are very vascular and as everyone will see
there’s gonna be a quite a significant amount of blood here okay we’re gonna go
ahead and cut some more out and cut this out we’re not cutting the
healthy skin we’re only cutting away [the granuloma] just dry this up a little bit here so I just want everyone to see here this has been a clearly a relatively complex
ingrown nail this is part of the root of the pyogenic granuloma we’re
not gonna go ahead and remove that we’ve removed the entire ingrown nail which was actually just embedded into this nail fold and this is
actually silver nitrate silver nitrate is used to chemically cauterize which
means to stop the bleeding and we’ll go ahead and just kind of place that in
there I like to put a little bit of pressure there it turns white because
it is a reaction and again the purpose of the silver nitrate is to actually stop the bleeding these granulomas will bleed and
bleed and continue to bleed there’s still a little bit of bleeding here on
the side and again with time all this discoloration will disappear leave that there for
about five seconds and that should do it super it is extremely important especially for
diabetic patients for patients with vascular disease or patients from all
walks of life these ingrown toenails need to be
treated properly to make sure that there are no long-term complications he’s going to be very happy and so are we if you guys have any questions always
feel free to reach out to us at thanks for watching

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