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. 2023 Dec;47(12):3101-3104.
doi: 10.1007/s00268-023-07147-6. Epub 2023 Sep 14.

Orthopaedic Wire Debridement: A Novel Surgical Technique for Hypergranulated Burn Wounds

Nathan Carl English  1 , Gary Dos Passos  2   3
Affiliations

Orthopaedic Wire Debridement: A Novel Surgical Technique for Hypergranulated Burn Wounds

Nathan Carl English et al. World J Surg. 2023 Dec.

Abstract

The burn wound healing process can be protracted due to various factors, including burn depth, infection and hypergranulation. Hypergranulation impedes epithelialisation macroscopically by preventing cellular migration across the wound bed and microscopically through cell-to-cell signal interferences. Debridement, which is the act of removing necrotic tissue, hypergranulation, slough and foreign debris from the wound in order to expose the underlying viable bed, can be achieved using various techniques. This aids with wound bed preparation to facilitate and expedite healing. In this article, we present a novel surgical debridement technique using a malleable orthopaedic cerclage wire for the management of a hypergranulated burn wound.

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Conflict of interest statement

The authors (mentioned above) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Hypergranulated islands amongst surrounding healed skin
Fig. 2
Fig. 2
a Cross section of orthopaedic cerclage wire cutting edge. b Cross section of planar blade cutting edge (e.g. Humby knife blade)
Fig. 3
Fig. 3
a Schematic representation of cerclage wire manipulated to replicate the contour of the body surface, thereby enabling equal distribution of force across the wound bed. b Schematic representation of unequal pressure distribution exerted by planar instruments resulting in overzealous debridement in the centre of the wound
Fig. 4
Fig. 4
Instrument held at distal wound margin, parallel to the body surface
Fig. 5
Fig. 5
Counter traction applied by assistant, whilst downward pressure is maintained and the instrument being drawn towards the surgeon
Fig. 6
Fig. 6
Hypergranulation tissue debrided en bloc, with preservation of surrounding healed skin at wound margin circumferentially
See this image and copyright information in PMC

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