How to effectively treat a non-healing nail wound?

Question

Hello doctor,

I underwent a nail bed revision surgery for an ingrown toenail two months ago, but the wound has not healed. There is a small hole-like opening at the surgical site from which pus occasionally drains, and it sometimes bleeds. The toe also becomes swollen from time to time.

I completed a course of oral antibiotics as prescribed by my doctor and have been doing regular dressings with povidone-iodine (Betadine). Despite this, the wound keeps reopening, bleeding, and getting infected.

I would like to know what could be causing this persistent non-healing wound and what further evaluation or treatment may be necessary.

Please help.

Thank you.

Answer 1

Hello,

Welcome back to icliniq.com.

I understand your concern.

I have seen the picture (attachment removed to protect patient's identity). The most common reason for a wound to fail to heal is diabetes or another systemic disease. However, you are young, and I do not expect any systemic disease in your case. Still, I would suggest getting routine blood tests, including HbA1c.

The next possible cause could be osteomyelitis of the underlying bone, which seems logical in your case. For that, I would suggest getting an X-ray. Moreover, if it is osteomyelitis, the antibiotics need to be specific to that.

If you already have an X-ray, I would suggest uploading it. Let me know if you have any other queries.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.