Equipment for Nail Trephination Cleansing solution such as chlorhexidine Nonsterile gloves Syringes and needles to give local anesthesia Cautery device (eg, disposable pen) or 18-gauge needle Alternatives: A 29-gauge insulin needle with attached syringe or a mesoscission device (which determines depth of nail boring using skin electrodes) Sterile gauze Additional Considerations for Nail Trephination Presence of a fracture does not contraindicate nail trephination; trephination does not increase the risk of infection.