Isla Bennett
Fingernail injuries are common, and often the result of a crushing or stubbing injury. This can lead to a subungual hematoma, which is when blood collects under the nail, causing pressure and pain. If left untreated, the pressure of the blood underneath the nail's surface may cause the nail to fall off partially or completely. To relieve the pain and pressure, a simple procedure called trephination can be performed, in which a small hole is made in the nail to drain the blood. This procedure is quick, relatively painless, and can be carried out in a doctor's office or urgent care center. However, it is important to note that home drainage methods should be avoided as they can cause pain and infection.
Should I drain a finger nail?
| Characteristics | Values |
|---|---|
| When to drain | When the hematoma causes pain or makes up 50% or more of the nail |
| When not to drain | If the trauma caused additional damage, such as a broken bone or deep cut |
| Drainage procedure | Clean the area, numb the finger, make a small hole in the nail to drain the hematoma, bandage the nail |
| Aftercare | Keep the finger bandaged and elevated, use cold compresses, soak the finger in warm water |
| Risks | Infection, nail bed injury |
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What You'll Learn
Draining a finger nail at home can lead to infection
Draining a hematoma (bleeding under the nail) can be done at home, but it is not recommended due to the risk of infection.
A subungual hematoma is a bruised fingernail or toenail resulting from blunt or crush trauma. Blood collects under the nail, causing pressure and pain. This pressure can lead to the nail coming off completely.
To relieve the pain and pressure, a small hole is made in the nail to allow the blood to flow out. This procedure, called trephination, can be performed quickly and relatively painlessly by a doctor. Draining a hematoma at home can lead to infection if proper care is not taken.
Infections can cause much more damage than the initial injury. Home drainage methods can cause pain and infection if not done correctly. Bacteria can enter the wound, leading to an infection. Signs of infection include warmth, redness, increasing swelling, and fever. If you notice any of these symptoms after draining a hematoma at home, seek medical attention immediately.
It is important to follow your doctor's instructions for caring for your finger or toe after treatment. In general, keep the area clean and dry, and follow their directions for changing bandages.
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A doctor may drain blood from under the nail
A subungual hematoma is a bruised fingernail or toenail resulting from blunt or crush trauma. Blood collects under the nail, causing pressure and pain. This pressure can be extremely painful, and to relieve it, a doctor may perform decompression, also called trephination, which allows the underlying blood to drain.
Before draining the blood, a doctor will first examine your nail and may take an X-ray to check for a bone fracture or other injuries. They may also recommend a simple procedure called trephination, which involves draining the hematoma to relieve pressure. If there is a broken bone, deep cut, or other injuries, the doctor may need to remove the nail plate to repair the tissues underneath.
The draining procedure involves numbing the finger or toe with a nerve block and then using one of several decompression methods, such as cautery or a hot paper clip, to create a hole in the nail. As soon as the hole is complete, blood will escape, and the pain will be relieved. After the procedure, the doctor will bandage the nail, and you will need to keep the finger or toe bandaged and elevated for the first 12 hours. You may also need to use cold compresses and a splint until the tenderness subsides.
It is important to watch for signs of infection, such as increased pain, swelling, redness, warmth, or pus, as there is a small risk of infection associated with decompression. If your pain does not go away after draining the blood, you may have a more serious injury, and you should call your doctor.
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Signs you need to drain a finger nail
A subungual hematoma is a bruised fingernail or toenail resulting from blunt or crush trauma. Blood collects under the nail, causing pressure and pain. Signs that you need to drain a fingernail include:
- Continuing, intense pain
- Signs of infection, such as pus, redness, or heat around the nail, or a red streak extending from the wound
- Swelling at the base of the nail
- Sensitivity to touch
- Deformity of the finger or toe
- More than a quarter of the nail is discoloured
If you notice any of these symptoms, it is important to seek medical attention. A medical professional can assess the severity of the injury and determine if drainage is necessary. They may recommend a procedure called trephination or decompression, which involves draining the hematoma to relieve pressure and pain.
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What to do after draining a finger nail
Draining a fingernail, or performing trephination, is a procedure to relieve pain and pressure caused by a build-up of blood underneath the nail. This is often a result of a bruised or crushed fingernail. After the procedure, it is important to follow the aftercare instructions provided by your doctor. Here are some general guidelines on what to do after draining a fingernail:
Keep the Area Clean and Dry
It is important to maintain proper hygiene and keep the affected area clean and dry. This will help prevent any potential infections.
Follow Bandage Instructions
Your doctor may apply a bandage to the area, and it is crucial to follow their instructions on changing the bandage. Keeping the wound covered will help protect it and promote healing.
Elevate and Apply Cold Compresses
In the first 12 hours after the procedure, it is recommended to keep the finger elevated and use cold compresses to reduce swelling and manage pain.
Soak in Warm Water
For the next two days, soak the finger in warm water every two hours to promote healing and drainage. This will help keep the area clean and aid in the recovery process.
Monitor for Complications
In some cases, there may be a small risk of infection or other complications. It is important to monitor the area for any signs of infection, such as redness, heat, or pus. If you notice any unusual symptoms or if the pain worsens, seek medical attention promptly.
Follow-up Appointments
Your healthcare provider may schedule follow-up appointments to monitor your recovery and ensure proper healing. Attend these appointments to ensure your fingernail is healing well and to address any concerns you may have.
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How to drain a finger nail
Draining a fingernail is usually done in the event of a subungual haematoma or a paronychia infection. A subungual haematoma is a bruised fingernail or toenail resulting from blunt or crush trauma. Blood collects under the nail, causing pressure and pain. A paronychia infection, on the other hand, is an infection of the skin around the nail, which can be caused by bacteria or fungi.
- Subungual Haematoma: If you have a subungual haematoma, your doctor may perform a simple procedure called trephination, which involves draining the blood to relieve pressure and pain. Your doctor will first numb the affected finger with a nerve block and then make a small hole in the nail to allow the blood to drain out. After the procedure, your doctor will bandage your nail and you will need to keep your finger elevated and bandaged for the first 12 hours. In some cases, you may also need to use a splint until the tenderness subsides. It is important to follow your doctor's instructions for changing any bandages and taking care of your finger after the procedure.
- Paronychia Infection: If you have a paronychia infection, the treatment will depend on the severity of the infection. For early infections, frequent warm soaks and a short course of antibiotics may be prescribed. For more established infections with pus collection, an incision and drainage procedure may be necessary. This procedure involves numbing the finger with ice water or a digital nerve block, cleaning the cuticle with a sterilizing solution, making a small incision under the skin parallel to the nail with a blade, and then draining the pus. After the procedure, it is important to soak the finger in warm water every two hours for the next two days to promote healing.
It is important to note that draining a fingernail is a medical procedure that should be performed by a qualified healthcare professional. Do not attempt to drain your fingernail at home without proper medical training.
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