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Dr. Andrew Rynne

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What causes pain and discharge after treatment of fungal infection in the toenail?

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16504 Questions

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Posted on Fri, 8 Jun 2018 in Lump
Question: Hi Doctor,
I was suffering with fungal infection in my toenail for which i visited doctor and he suggested for removal of the same and he did the surgery on 29th dec 2017. After which he gave me augmentin 625 for 4 days and azithral for 3 days but still i have pain and some discharge is still there in the bandages. Please advise i have attached pics of the each stage including before surgery and after surgery pics of 4th, 5th and 9th day.
Please suggest some ointment or medication which would heal the wound faster.
doctor
Answered by Dr. T Chandrakant 47 minutes later
Brief Answer:
Hydrogen peroxide and Liquid Povidone Iodine

Detailed Answer:
Hi.
Thanks for your query.
Noted the history and seen the photos that you have posted.
I would advise you the following in such a situation:
Clean the wound with copious amount of hydrogen peroxide till the debris is removed. Then apply liquid povidone iodine that is Betadine to the whole toe and also clean the whole foot with Liquid Betadine.
Apply only a few layers of cotton bandage to the toe and pour Liquid Betaine 2 - 3 times a day.
You may repeat this for a few day till the wound looks fresh and then change the dressing once a day only.
Do not rub over the wound as it disturbs the neo-epithelium.
Also take Multivitamins as it helps in better wound healing.
Keep the foot elevated above heart level in lying down position when resting.
Avoid long sitting and standing.
Use no ointments at the moment.
Continue the pain killer till the pain is gone.

All these things will give the best of healing at the earliest. Surgery done is great, it takes more time for the wounds at the lower limbs to heal in general so do not worry.
Take care.
Post photos after a few days of the wound care as explained above.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 8 minutes later
Hi Doctor,
Thank you for the advise just a small query how much time does it takes to heal from this surgery as currently i have to bandage as well as currently not able to wear shoes
doctor
Answered by Dr. T Chandrakant 2 minutes later
Brief Answer:
2 - 3 weeks

Detailed Answer:
It take 2 - 3 weeks for such wounds to get healed and well covered up if there is no other problems like vascularity issue, smoking, diabetes or so.
Not wearing or unable to wear shoes is understood as the wound is at the toe- use sandals.
Take care.
Post follow up photos.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 11 hours later
Hello doctor,
I have uploaded today's picture. The only issue I face today is there is swelling on the lower portion of thumb which is paining a lot when pressed. My doctor advise to take zifi 200 for two days bidaily. Please check and advise
doctor
Answered by Dr. T Chandrakant 5 minutes later
Brief Answer:
As discussed

Detailed Answer:
Please do not press or fondle the area.
By the picture you have posted there does not look to be any active infection.
Yet take Zifi as advised and for 5 days.
Continue flozen AA twice daily or as advised .

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 43 hours later
Hello doctor,
I have uploaded pictures of today. The swelling is less but pain is there and redness is there on the lower portion of the thumb above the hairs on the thumb.
I am continuing to take zifi 200 and flozen AA twice a day please check and advise
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
looks fine

Detailed Answer:
Thanks for clear picture.
The wound looks fine and nothing to worry about.
Healing wounds can give some tenderness as the nerves are pared while the nail is removed from the nail-bed and will go away.
Does not look to have any infection, yet continue the course of the medications you are taking for a few more days.
Continue the dressing as advised.
It may be needed to remove the dead skin layer at the outer side of the healing wound.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 23 hours later
Hello doctor,
My leg is swelled and swelling is more on the ankle portion. I have uploaded the picture. Please advise.
This is happening when I am in office
doctor
Answered by Dr. T Chandrakant 47 minutes later
Brief Answer:
Elevation above heart level

Detailed Answer:
As said earlier, avoid long sitting or standing hours; this can cause the edema to appear.
I hope there is no pain in ankle joint.
When at home, raise the heel above heart level in lying down position so that the edema will reduce.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant 8 minutes later
No doctor i don't experience pain while resting but yes it is stressful when standing. Completely avoiding sitting or standing is not getting possible as can't get so many leaves from office but will try as much as possible to raise above heart level.

Does this require any medication.

Thank you
doctor
Answered by Dr. T Chandrakant 4 minutes later
Brief Answer:
No specific medications

Detailed Answer:
There are no specific medications as this is due to dependent edema.
At least walk around in office as much as possible.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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