Hi Pied
I've just been reading your thread. What an awful mess and what a lot of stress for you at a time when you could obviously do without it.
I'm a chiropodist and from the look of your mum's toe in the photo it looks like a classic infected ingrowing toenail. I was taught that you can't do anything until the infection has gone - it's too painful and you simply can't get at it because of all the hypergranulation tissue which is soggy and tends to bleed as soon as you look at it. It certainly needs dressing. Bathing in salt water is good too. That's a good fistful of salt in a bowl of bath hot water (or whatever temp is comfortable for mum) not just a sprinkle, and no more than 10 mins - only problem is, salt does dry out the skin. An Inodine dressing might help (so long as mum is ok to have iodine - i.e. no thyroid problems).
Once the infection has gone a chiropodist/podiatrist should be able to get a probe down the side of the nail to see if it is ingrowing. It may be a simple case of filing a bit of nail off to smooth it out so that it doesn't break the skin and allow infection in again. The worst case is where a splinter of nail pierces the skin at the side of the nail and continues to grow. It is possible to remove these, but is rather painful. So by 'surgery' they might simply mean that your mum would have to have a 'ring block' local anaesthetic to numb the toe so they can get in there and sort it out. That might even involve removing a wedge of nail and killing off a small area of the nail matrix so it doesn't grow again (not always 100% successful I have to add). This is called a 'partial avulsion' of the nail. This is not something I actually do as I'm not certified for anaesthetics. I have, however, sorted out ingrowing nails without using them. A lot would depend on your mum's compliance and her pain threshold. Is your mum diabetic?
Meanwhile, what the **ll is this home playing at? Haven't they got a chiropodist who makes regular visits? I can't believe no one had seen to her feet for 5 months
Until recently I did the residents' feet in my mum's CH. Whenever a new resident came in I would be asked to add the person to my rota. If I couldn't actually treat them that day I would have a quick look just to make sure there was nothing that needed doing urgently and then arrange to go in as soon as possible (which was easy as the home is in my village). If a resident had a problem I hadn't been told about I would go and get the manager and show her and advise her to call the GP/nurse or tell her what treatment was needed (and put it in writing).
Hope you get this sorted out soon.
Chris