Hello, paronychia refers to a purulent infection of the soft tissue around the (toe) nail. It is caused by bacteria that invade the subcutaneous tissue through minimally invasive damage to the paraungual skin and grow and multiply. In the fingers, it is often caused by injuries such as puncture wounds, peeling off flesh thorns, or pruning nails too deeply. In the toes, it is often caused by ingrown toenails or shoes that are too tight, mostly in the thumb. Paronychia is more common in teenagers or women. Generally, it can occur on the fingers or on the toes. People who develop it on the fingers often have a bad habit of biting their fingers. People who develop it on the toes are often caused by secondary infection of ingrown toenails. In the toes, it is often caused by ingrown toenails or shoes that are too tight, mostly in the thumb.

Treatment with traditional Chinese medicine

1. Internal treatment with traditional Chinese medicine: you can use Wuwei disinfectant drink to clear away heat and detoxify, and Coptis detoxification decoction. If the poison is severe and swollen, add green leaves, soap thorns, etc.; if you have high fever and are thirsty, add raw gypsum; if the stool is dry and hard, add rhubarb, Xuanming powder, etc.; if the pain is unbearable, add Xihuang Pills. (For reference only)

2. External treatment with traditional Chinese medicine: For local redness and swelling that has not ulcerated, use or Or apply it externally. If the pus is uncomfortable, add medical thread for drainage; in the later stage, you can use Shengjisan Etaiyi ointment or red oil ointment to cover it.

Treatment measures

In the early stage, pure traditional Chinese medicine products, hot compresses, physical therapy, etc. can be used, as well as sulfa drugs or antibiotics. If pus already exists, longitudinal incision and drainage can be made at the nail groove. When the infection has affected the subcutaneous surroundings of the nail base, longitudinal incisions can be made in the nail grooves on both sides, the epithelial sheet of the nail root is turned up, the nail root is removed, and a small piece of Vaseline gauze or latex sheet is placed for drainage. If pus has accumulated under the nail bed, the nails should be pulled out or the nails above the abscess cavity should be cut off. When removing the nail, care should be taken to avoid damaging the nail bed to avoid deformation of the new nail in the future.

General conservative treatments for paronychia:

(1) Antibiotics

There are many types, including intramuscular injection, intravenous medication, external medication and other types.

Advantages: It has a strong inhibitory effect on bacteria and has certain anti-inflammatory and analgesic effects.

Disadvantages: It seems to have no effect on ingrown toenails caused by physical toenail penetration.

(2) Anti-inflammatory analgesics

Such as salicylic acid preparations, etc., available in oral, ointment, injection and other types.

Advantages: It can reduce pain and swelling, suitable for use when the pain is unbearable.

Disadvantages: It is ineffective in treating ingrown toenails. If used for a long time, it will cause greater irritation to the gastrointestinal tract. People with gastrointestinal diseases should use it with caution.

(3) Urea ointment

Advantages: It can soften the skin and toenails, helping to correct them.

Disadvantages: It takes a long time to soften toenails, is very troublesome, and the effect is not good when used alone. That is, even if the toenails are softened, it is difficult to cure the deformation of the toenails without the use of correction methods.

(4) Silver nitrate

Advantages: There is less pain during treatment, usually no anesthesia is required, the granulation tissue can be flattened, and it has an inhibitory effect on pus and exudation.

Disadvantages: It is corrosive to a certain extent and will darken the skin and toenails, seriously affecting the appearance. It only has an effect on granulation tissue and does not help much in the correction of toenails.

(5) "Cotton plug method" and "hose plug method"

Advantages: simple and convenient, can be handled by yourself.

Disadvantages: easy to fall off, insufficient packing power, poor effect, easy to relapse.

Use a drip hose instead of cotton to fill the nail groove and glue it with special glue.

(6) Traditional Chinese Medicine Therapy

External application of traditional Chinese medicine preparations, soaking of Chinese herbal medicine, etc., or traditional pedicure techniques.

Advantages: Usually there are no side effects, and it is better at eliminating inflammation.

Disadvantages: The effect of radical treatment needs to be determined based on the doctor's personal experience, and there is no unified standard.

(7) Surgical treatment

Not all patients with paronychia are suitable for incision and drainage. Clinically, those with pus accumulation in paronychia should undergo incision and drainage. Preoperative preparation:

1. Choose antibiotics reasonably according to the condition.

2. For those with severe hand infection and weak general condition, attention should be paid to improving the general condition and increasing the body's resistance.

3. When incising a deep abscess on the hand, it is advisable to use a tourniquet to control hemostasis to make the surgical field clear and ensure surgical safety.