Nailbed Injuries Follow-up
- Author: Darrell Sutijono, MD; Chief Editor: Trevor John Mills, MD, MPH more...
Further Outpatient Care
In general, except for a simple subungual hematoma in which the nailbed was not inspected for potential laceration or injury, a wound check in 2-5 days is suggested to check for infection and to repack the nail fold, if necessary.
Sutures should be removed from any replaced nail in approximately 2-3 weeks.
If acrylic nail, hypodermic syringe sheath, or other material was used as a stent, it should be removed in 3 weeks.
If the original nail was used as a splint, it will be pushed out as new nail grows in, and it will fall out on its own.
Inpatient & Outpatient Medications
The prophylactic use of antibiotics is indicated, depending on mechanism and extent of injury, such as for crush injuries and human bites or animal bites. Although the benefit of prophylactic antibiotics has not been proven, even if an open fracture of the distal phalanx is present, to be safe, many clinicians still prescribe a first-generation cephalosporin when bone or joint is exposed below a nailbed injury. A large, randomized controlled study may be necessary in the near future to examine the utility of antibiotics in such circumstances.
Complications of nailbed injuries may include the following:
- Loss or obstruction of the nailfold
- Destruction of nail with lack of new nail growth
- Abnormal nail growth or disrupted nail growth
Nailbed injuries generally heal well with appropriate treatment, although it may take months to years for the nail to grow back into the proper shape.
All patients should be advised that a deformed nail is a possibility.
New nail growth may take from 3-12 months and even then, it may be misshapen for a longer time.
If problems with new nail growth exist at 6 or 12 months, patients may want to follow up with a hand surgeon for possible scar excision or nailbed revisions.
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