ABSTRACT
All types of nail surgery, whether diagnostic or therapeutic, should take into account both the functional aspect and the cosmetic appearance. Nail surgery is usually performed using local anesthesia and, in most cases, a tourniquet. Epinephrine is not used with a tourniquet, in young children, heavy smokers, and elderly persons. Surgery of the nail is not recommended in high-risk patients, but the importance of systemic disease in nail abnormalities and of risk factors for nail surgery is often overemphasized. Anxiety is due to fear of needle prick and heightens the perception of pain; hydroxyzine taken at bedtime the day before surgery and a short-life benzodiazepine sublingually 1 hour prior to surgery are very effective. A sensory disturbance was observed in about half of the patients without any relationship to the extent of the surgery undertaken. Recurrences depend on the nature of the original lesion and the type and extent of surgery.
