Furthermore, the flesh can become injured by concussion, tight socks, quick twisting motions while walking, or simply because the nail is growing incorrectly (likely too wide). This hypersensitivity to continued injury can mean chronic ingrowth; the solution is nearly always edge avulsion by the more effective procedure of phenolisation. If the nail becomes ingrown again after a wedge resection, more invasive surgery may be needed, although this rather drastic measure may not be necessary: less invasive repeat treatments such as destruction of the nail bed, should be considered. This surgery takes longer than the minor wedge resection. The toe is torniqued and incisions made from the front of the toe to around 1 cm behind the rear of the visible part of the nail. These incisions are quite deep and will require stitching and will also scar. The nail will then be cut out, much like a wedge resection and the nail bed will be broken to prevent regrowth. The nail will be significantly narrower and may appear visibly deformed but will not become ingrown again. Note: if undertaking this surgery it is advisable to rest for at least four days before resuming regular walking as even with painkillers this can be very very painful. If one's work requires standing up for extended periods of time, arrangements for time-off may be necessary for up to two weeks. In case of recurrence after complete removal, and if the patient never felt any pain before inflammation occurred, the condition is more likely to be "onychia" which is often confused for an ingrown or ingrowing nail ("onychocryptosis"). Complete removal of the whole nail is a simple procedure. Anaesthetic is injected and the nail is removed quickly by pulling it outward from the toe. The patient can function normally right after the procedure and most of the discomfort goes away in a few days. The entire procedure can be performed in approximately 20 minutes and is less complex than the wedge resection. The nail often grows back, however, and in most cases it can cause more problems by becoming ingrown again. It can get injured by concussion and in some cases grows back too thick, too wide or deformed. This procedure can result in chronic ingrown nails causing more pain. Accordingly, in some cases as determined by a doctor, the nail matrix is coated with a chemical (usually phenol) so none of the nail will ever grow back. This is known as a permanent or full nail avulsion, or full matrixectomy, phenolisation, or full phenol avulsion.