A local anaesthetic is injected into the big toe, prior to wedge resection (partial excision) of an ingrowing toenail. A tourniquet in the form of an elastic band has been applied to reduce bleeding during the operation. Ingrowing toenails are nails in which one or both edges press into the adjacent skin, leading to pain, inflammation and infection. They arise from a variety of causes, notably the wearing of ill-fitting shoes and lack of attention in cleaning and trimming the nails. They commonly occur in the elderly or infirm, often due to inflammatory changes that cause ulceration of the skin on the sides of the toes.