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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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