In case of bacterial paronychia, we only intervene surgically when the infection is important: we do not perform surgery in the first inflammatory stage where there is only redness, local heat, slight edema, pain touch. Only when the purulent collection is present and the pus must be evacuated will the surgical act be performed.
Before consulting, when we notice the first signs of the appearance of a paronychia, we can provide simple local care that can reduce the infection.
We can start by disinfecting the wound with a cutaneous antiseptic solution (hexamidine, chlorinexidine, povidone iodine, Dakin solution). Before using the surgical procedure, it is possible to intervene with oral antibiotic treatment (antistaphylococcal antibiotic therapy).
However, if we give the antibiotic treatment before we have been able to identify precisely the germ that caused the infection, we will not know which treatment is best adapted to fight it. In this case, it will be a "probabilistic" treatment, hoping that it actually corresponds to the germ that is suspected to be responsible for the paronychia.
When it is necessary to intervene surgically, if the paronychia is still in an initial phase, it will be an extremely simple surgical procedure, performed in the dermatologist's office or the general practitioner's office. The paronychia surgery involves the excision of the infected tissues around the nail.
The surgical procedure becomes more technical and complex when the paronychia is taken care of later and / or if there are complications (an infection that goes back to the level of the tendinous sheaths, for example). In this case, it is a surgical operating theater.
Herpetic whitlow can be treated with local antiseptic treatments, or in its most important forms, with general antiviral treatments (aciclovir or valaciclovir). In this case, one does not intervene surgically, one can just possibly drill slightly vesiculo-pustules.