The average cost to the operative group was $1,263 compared with $283 to the trephination group.

Is nail trephination necessary?

Subungual hematomas should be treated with nail bed trephination, as the progressive pressure from fluid accumulation is painful. This is easily done with an 18-gauge needle and universal precautions.

Does nail trephination hurt?

Reassure the patient that trephination takes only a few seconds and is almost painless—much less so than a digital block. If the patient cannot be reassured, anesthetize the distal finger with a digital block.