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Review

An Update for UK Podiatrists Performing Toenail Surgery on Patients Who Are Taking Antithrombotic Medications: It’s About Bleeding Time

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This version is not peer-reviewed

Submitted:

22 May 2021

Posted:

24 May 2021

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Abstract

Nail surgery for the permanent removal of all or part of the nail unit can be performed via incisional or physically ablative techniques for conditions such as ingrown, mycotic, or dystrophic toenails. In the United Kingdom podiatric community, where phenol techniques are the standard of care for ablation of the matrix, there remains confusion about the management of patients undergoing nail surgery who are concurrently taking antithrombotic medication(s). The aim of this paper was to review the literature describing treatment strategies for antithrombosed patients undergoing nail surgery. However, having found limited evidence, the authors considered relevant and associated literature in the field of cutaneous/dermatological surgery and extrapolated those findings for patients undergoing nail avulsion surgery. A case-by-case risk assessment is warranted in all patients but as a general rule, the podiatrist can perform nail surgery without the patientceasing their antithrombotic medication.

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Subject: Medicine and Pharmacology - Immunology and Allergy

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