06/10/2020    Michael M. Rosenblatt, DPM

rinding Nails During the COVID-19 Pandemic (Bryan Markinson, DPM)

Bryan C. Markinson, DPM, warned us about the
risks of grinding nails and breathing in the
detritus and fomites that erupt in that “cloud.”
He states he has not ground nails for years. I
practiced during the HIV-AIDS crisis. I treated
infections, did open debridement’s, and ground
nails for those patients. Those who grind nails
all recall the experience of accidentally
touching the nail grove with the spinning grinder
and erupting into a shower of blood that would go
into our face, nose, eyes and mouth, even if
partially covered by a mask and eye protection.

Unfortunately, avoiding this is not an easy
answer. Sometimes hypertrophic, fungal nails are
a real problem in fitting into shoe gear for
diabetics and other fragile patients. Removing
them surgically is not always an answer, as some
of these people have very poor circulation and
removing the nails is still a surgery. If they
don’t heal or get infected, it is usually
considered OUR fault. Attempts to fragment nails
mechanically is a good skill, but can result in a
lot of pain for patients and an "inadvertent"
surgery.

I ground nails when necessary. I still have some
respiratory issues as a result of this practice.
Not long ago, a British medical journal discussed
this as a “necessary part of podiatry and
certainly an occupational risk.”

I think it is still necessary to grind nails,
although I understand the risks. I would probably
invest in the best equipment possible to vacuum
up the fomites, with the clear understand that
complete ablation is impossible.

I can understand why you do not. But I think it
is still necessary for some patients. I tended to
accept the advantages and disadvantages of
podiatry, in all its splendor.

Michael M. Rosenblatt, DPM, Henderson, NV

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