CHAPTER 35 Subungual Hematoma Evacuation
Contraindications
• Hematomas involving greater than 50% of the nail may indicate laceration of the underlying nail bed. (Removal of the nail and repair of the laceration is recommended by some experts to avoid a post-traumatic nail deformity. Others recommend leaving the nail in place as a splint. The patient should be warned that the nail may be deformed unless the nail bed is examined and treated.)
Technique
1 Wash the digit as thoroughly as possible with an antibacterial soap to decrease the possibility of contamination of the hematoma and subsequent infection.
2 Consider a digital block with lidocaine without epinephrine because any pressure on the area can be painful.
3 Create a hole in the nail directly over the center of the hematoma to allow decompression.