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簡單的說，就是拔指甲

• With the patient in a relaxed, supine position, scrub and drape the toe in a sterile fashion.
• Administer local anesthetic (5 ml total) in ring-block as described above.
• When anesthesia is achieved (5 to 10 minutes), use a straight hemostat to firmly secure a wide rubber band around the base of the toe to serve as a tourniquet.

oosen and lift the nail from the nail bed by using the flat, pointed blade of a pair of scissors, a single jaw of a straight hemostat, or a narrow periosteal elevator. Introduce and advance the instrument with continued upward pressure against the nail and away from the nail bed to minimize injury and bleeding. It is important to completely free the proximal nail at its base under the edge of the cuticle to allow removal and to expose the germinal tissue of the nail bed. Separate at least 25% of the nail for a partial nail removal or loosen the entire nail for a complete nail removal.

For a partial nail removal, use scissors or a nail splitter to completely split the nail in a longitudinal direction to include the base of the nail that rests beneath the cuticle.

Grasp that portion of the nail to be removed lengthwise with a straight hemostat and remove it, using a steady pulling motion with a simultaneous upward twist of the hand toward the affected side. This twisting action will ensure that the nail will be rolled out from beneath the affected nail margin instead of rolling over it. If the entire nail is to be removed, the nail may be removed in two halves or in its entirety, following a thorough loosening and lifting of the nail. In removing the entire nail, the forceps should produce lifting and distal traction on the nail as it separates from the nail bed.

使用設備

Equipment

• 3 ml or 5 ml syringe with long (1 or 1.5 inch) 25- or 27-gauge needle
• Local anesthetic without epinephrine.
• A narrow periosteal elevator (nail elevator)
• Sterile scissors with straight blades or nail splitter
• Rubber band or small Penrose drain
• Two straight hemostats
• Alcohol swabs
• Sterile gauze and tubular gauze dressing
• Topical antibiotic ointment
• If desired, phenol solution (88%) or a radiofrequency electrosurgical unit with a Teflon-insulated matrix tip

不過提醒各位，多數患者會一再復發，尤其是夏天穿著悶濕的鞋子過久，發炎情況會更嚴重，就醫時只好動手術拔掉部分指甲，約需半年恢復期。

傳統拔指甲的方法是將麻藥注射在腳大拇趾上，等藥效發揮後以手術器材掀起腳指甲做部分修剪，之後上藥、包起厚厚的紗布，1個月以上該部位不能碰水，等新指甲長出來。不過這種處理法只能治標，復發率約70至80%。新的手術技術不只拔除部分腳指甲，連部分腳指甲上方在皮膚下的部分生長點都做切除，修整成合適大小與形狀，等於是做「指甲整形」，又稱甲床重建術。可另外再搭配指甲照光技術，加快復原，一隻趾頭治療費用為1萬8000元。

最後，這邊有嵌甲的手術影片給大家參考：