Nail bed repair: Splinting of the nail bed

The repaired nail bed can be protected (if there is also an injury to the proximal nail fold or a comminuted, displaced tuft fracture) by placing the original nail back into the proximal fold (eponychium) and securing it with wound adhesive (eg, Dermabond, Surgiseal, Histoacryl Blue, or Periacryl) or nonabsorbable suture. The nail should undergo trephination prior to replacement to permit drainage. If the nail cannot be used, trimmed sterile foil from the suture pack, a single-thickness of nonadherent gauze, or a 0.2-inch silicon sheeting may be placed instead.