Trephination of a Fingernail Subungual Hematoma with Cautery

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How to use electrocautery to trephinate a subungual hematoma, demonstrated by Dr. Jess Mason.

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Tags Cautery Electrocautery Subungual Trephination

Jenna S. -

How long since the injury has occurred that you would still attempt to drain a subungual hematoma? Like no point attempting it if it’s more than 24 hours? Thanks!

Jess Mason -

I'm not aware of a specific time frame. It's to make them feel better, so if they are still having pain then I'd do it.

Allen J. J. -

Also, if you use an alcohol wipe, dry it completely first. Many years ago, I turned my patient's finger into a birthday candle doing this. The fire was quickly extinguished with no harm done, and I made light of it (no pun intended) as though it was something that happened all the time.

Will McGill -

Same thing happened to me when I prepped with chlorhexadine the very first time I used electrocautery to drain a subungual hematoma. I (and my staff) will never forget it.

Vekram -

Haha, great tip!

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