Periungual bacterial flora in the human foot

Proper presurgical preparations are presumed to eliminate organisms from the skin, nails, and nail grooves. It has not been documented as to whether surgical scrubs reduce the types and numbers of bacteria and thereby affect the incidence of infection in performing toenail surgery. This study, performed pre- and postsurgical scrub cultures of four sites on 40 subjects. Similar cultures from ten additional patients who underwent nail surgery were also performed. The later set had an additional set of cultures performed after avulsion of the nail plate and the beginning of the actual surgical procedure. Blood cultures were done intraoperatively on the surgical patients. Results revealed that nail grooves are difficult, if not impossible, to antisepticize. The usual presurgical scrub does not eradicate bacteria in these areas. As such, nail surgery must certainly be considered dirty surgery and precautionary measures must be considered.