HWN Suggests

Paronychia

When draining a paronychia, I prefer to use an 11 blade laid flat on the nail to make a small incision, then lifting the skin slightly away from the nail. While some tolerate the procedure well, I do offer a digital block to alleviate any apprehension. For those with more extensive involvement, you may place a wick with a short piece of 1/4" iodoform and have the patient remove it in 1-2 days. Be sure to offer a wound check in 48 hours - either in the ED or an urgent care if available. Counsel the patient that the finger will not look completely normal for 1-2 weeks but we want to see a steady improvement over that time.

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 Pointing The Finger – Paronychia In The Emergency Department

t’s odd how we seem to find ourselves with very niche interest areas in Emergency Medicine. Paronychia is one of mine, for a variety of reasons – probably firstly because I used to be a nail-biter and so had a lot of paronychia growing up, secondly because I had some great teaching from some Nurse Practitioners on the topic early in my ED career and thirdly because I made a Borat-themed Paronychia quiz for registrar teaching when I was a trainee that I remain unjustifiably proud of.

Articles of Interest

The Clinical Approach to Paronychia

In fact, there is no surgery to recommend unless pus is present; one is dealing with a simple cellulitis. I advise patients to soak their affected finger in a coffee cup filled with very hot tap water (not boiled water or sterile saline) for 10 minutes, four times a day.