Potential Complications and Their Management

  • Bertrand Richert
  • Nilton Di Chiacchio
  • Marie Caucanas
  • Nilton Gioia Di Chiacchio


Complications may be reduced to a minimum by preventive measures, such as careful patient selection, sterile technique, accurate procedure and meticulous care of the nail matrix. The nail surgeon should never abandon a patient showing complications. The more surgery is performed, the more complications may arise. Their recognition and management is part of the patient’s follow-up.


Nail Complications Infection Dystrophy Necrosis Post op pain Dysesthesia Bleeding Reflex sympathetic dystrophy 


  1. 1.
    Richert B, Dahdah M. Complications of nail surgery. In: Noury K, editor. Complications in dermatologic surgery. Philadelphia: Mosby; 2008. p. 137–58.Google Scholar
  2. 2.
    Johansson O, Fantini F, Hu H. Neuronal structural proteins, transmitters, transmitter enzymes and neuropeptides in human Meissner’s corpuscles: a reappraisal using immunohistochemistry. Arch Dermatol Res. 1999;291(7–8):419–24.CrossRefPubMedGoogle Scholar
  3. 3.
    Paré M, Elde R, Mazurkiewicz JE, Smith AM, Rice FL. The Meissner corpuscle revised: a multiafferented mechanoreceptor with nociceptor immunochemical properties. J Neurosci Off J Soc Neurosci. 2001;21(18):7236–46.Google Scholar
  4. 4.
    Walsh ML, Shipley DV, de Berker DAR. Survey of patients’ experiences after nail surgery. Clin Exp Dermatol. 2009;34(5):e154–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Alcalay J, Alkalay R. Controversies in perioperative management of blood thinners in dermatologic surgery: continue or discontinue ? Dermatol Surg. 2004;30:1091–4.PubMedGoogle Scholar
  6. 6.
    Kovich O, Otley CC. Thrombotic complications related to discontinuation of warfarin and aspirin therapy perioperatively for cutaneous operation. J Am Acad Dermatol. 2003;48:233–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Karabagli Y, Kose AA, Cetin C. Toe necrosis due to a neglected tourniquet. Plast Reconstr Surg. 2005;116:2036–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Andrades PR, Olguin FA, Calderon W. Digital blocks with or without epinephrine. Plast Reconstr Surg. 2003;111:1769–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Lazar A, Abimelec P, Dumontier C. Full thickness skin graft for nail unit reconstruction. J Hand Surg. 2005;30:194–8.CrossRefGoogle Scholar
  10. 10.
    Roca B, Climent A, Costa N. Reflex sympathetic dystrophy after nail surgery. Ann Med Interna. 2000;17:506.Google Scholar
  11. 11.
    Ingram GJ, Scher RK, Lally EV. Reflex sympathetic dystrophy following nail biopsy. J Am Acad Dermatol. 1987;16:253–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Bennett DS, Brookoff D. Complex regional pain syndromes (reflex sympathetic dystrophy and causalgia) and spinal cord stimulation. Pain Med. 2006;7 Suppl 2:S64–96.CrossRefGoogle Scholar
  13. 13.
    Tosti A, Baran R, Peluso AM, et al. Reflex sympathetic dystrophy with prominent involvement of the nail apparatus. J Am Acad Dermatol. 1993;29:865–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Vanhooteghem O, Andre J, Halkin V, Song M. Leuconychia in reflex sympathetic dystrophy: a chance association? Br J Dermatol. 1998;139:355–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Bertrand Richert
    • 1
  • Nilton Di Chiacchio
    • 2
  • Marie Caucanas
    • 3
  • Nilton Gioia Di Chiacchio
    • 4
  1. 1.CHU BrugmannUniversité Libre de BruxellesBrusselsBelgium
  2. 2.Dermatology ClinicHospital do Servidor Público MunicipalSão PauloBrazil
  3. 3.Clinique St Jean LanguedocToulouseFrance
  4. 4.Hospital do Servidor Público MunicipalSão PauloBrazil

Personalised recommendations