Practical podiatry : . ment, the tissue would in time present a perfectly normalappearance. That is, the exuberant granules would sooner or later develop an epi-thelial covering whichwould be of like appear-ance to the normal sur-face of the skin. But indoing so, the tissueswould still retain theshape and size of theoriginal mass of exu-berant granules and wewould find a teat of tis-sue, the size of a pea,jutting out of the nor-mal surface of the nailgroove. Keeping in mind,then, that to obtain aspeedy and normalhealing action in awound the proud fleshpresent must be eradi-cated, it should app


Practical podiatry : . ment, the tissue would in time present a perfectly normalappearance. That is, the exuberant granules would sooner or later develop an epi-thelial covering whichwould be of like appear-ance to the normal sur-face of the skin. But indoing so, the tissueswould still retain theshape and size of theoriginal mass of exu-berant granules and wewould find a teat of tis-sue, the size of a pea,jutting out of the nor-mal surface of the nailgroove. Keeping in mind,then, that to obtain aspeedy and normalhealing action in awound the proud fleshpresent must be eradi-cated, it should appealto the operator that thequickest means for itsremoval must be the best. Two quick and complete methodsfor obtaining this desired result are found in (1), excision(by the use of the scalpel or curved scissors), and in (2), theactual cautery. Excision. Excision of the proud flesh cannot be resortedto in all cases, but in most cases at least the larger portion ofthe exuberant granulations can be removed in this BEGINNING INGEOWN TOE NAIL ONYCHOCRYPTOSIS OR INGROWN TOE NAIL 223 The condition in which the use of the cnn^ed scissors isparticularly advocated as most efficient is that in which themass of proud flesh is found in pendulous form, where itsbase is narrow and covers but a small area and where themass expands into an enlarged extremity. In cases where theproud flesh is found generally throughout the nail groove,and in some instances under the lateral edge of the nailitself, the scissors or scalpel cannot be used with good effect,if at all. Then of course other means must be employed. Method of Procedure. After the field of operation hasbeen thoroughly sterilized and the ingrown portion of thenail has been located and removed, the exact situation andamount of proud flesh is ascertained. If at all practical, asterile scissors (preferably of the curved variety) is insertedunder the granulating mass and the whole is quickly snippedoff at its junction with the normal


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