What is included in the dermatologic preoperative evaluation and management of toenail surgery?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

The most specific evaluation related to toenail surgery is the adequacy of the peripheral vascular system. Assessment of peripheral vascular disease can be obtained by history. Intermittent claudication or evidence of arteriosclerotic disease in other sites, such as the heart or the brain, are indicative of vascular disease. Peripheral pulses should be palpated before toenail surgery. Cutaneous signs of vascular insufficiency include thin, shiny skin; thickened, ridged nails; absence of dorsal digital hair; and dependent rubor followed by a pallor with elevation. Appropriate consultation and vascular flow studies may be indicated.


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