# Nail Trephination

## Overview

This module describes how to make a small hole or holes in the nail plate to allow for the drainage of a painful subungual haematoma.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“I am going to use a needle to pierce the nail and allow the blood underneath to drain away. Afterwards, the nail will grow out and the hole will disappear.”

### What can my patient expect?

“Usually, this is a very quick and painless procedure; however, I can give you a series of injections that will numb your finger, but they might hurt more than just making the hole in the nail.”

### What is my patient’s role?

“Let me know if you have any allergies. Fearing blood or needles is normal, but tell me if you have fainted from it. Tell me if you feel any severe pain. Afterwards, keep the area clean and dry and avoid soaking the finger.”

## Preparation

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### Documentation

### Equipment

## Site & Positioning

Position the patient with the finger flat on a surface and within easy reach.

## Procedure

Follow medical asepsis with non-sterile gloves.

## Troubleshooting

The blood didn’t drain.

Older haematomas may not drain as the blood may have congealed. Some haematomas require more than one hole to drain sufficiently.

## Risks

## References