Up in Flames: The Safety of Electrocautery Trephination of Subungual Hematomas with Acrylic Nails.

Introduction: Subungual hematomas are fingertip injuries, generally secondary to blunt trauma, that cause pain due to an accumulation of blood under the fingernail. It is generally considered standard of practice to relieve this accumulation by means of trephination with a hollow tip needle, a heated paper clip, or electrocautery. It has been assumed that due to the flammable properties of acrylic, trephination via electrocautery has the potential to ignite acrylic nails and cause burns and other potentially serious injury, making electrocautery contraindicated in patients with acrylic nails.