Nail bed injuries in children are very common. The subject of an information campaign by BAPRAS (British Association of Plastic Reconstructive and Aesthetic Surgeons) in 2017 to prevent injury, they are generally caused by a child crushing their fingertip in a closing door. In many cases surgery is performed to repair the underlying nail bed tear. Over 10,000 operations are performed in the UK alone each year.
Two treatment options are available during surgery. Children either have their fingernail placed back on the injured nail bed after the operation, or it is discarded entirely. Current practice sees about 96% of surgeons replacing the nail, but the new study questioned whether this approach had an impact on infection rates and whether it was cost-effective compared with throwing the nail away.
Abhilash Jain, Associate Professor of Plastic and Hand Surgery at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Oxford explained: 'The rationale behind reattaching the nail is that it protects the repair, reduces infection and is less painful when the dressings need to be changed. However, there was no evidence to support this practice, and while many papers have been published explaining how to put the nail back, there weren't any telling you why you should put it back.'