Injury, Int. J. Care Injured 34 (2003) 954–956

Skin edge debridement made easy

Gavin Pereiraa,∗, Clifford Pereiraba SpR in Trauma and Orthopaedics, Coventry and Warwickshire Hospital, Coventry, UK

b Clinical Research Fellow, Burns and Plastic Surgery, South Manchester University Hospitals, Manchester, UK

Accepted 4 February 2003

Abstract

A simple technique to obtain more linear skin edges during wound edge debridement, using a dissecting forceps and scalpel, is presented.© 2003 Elsevier Science Ltd. All rights reserved.

1. Introduction

Excision of non-viable skin edges is an important step inwound debridement[1,2,9]. Very often, the lacerated woundhas jagged edges or has non-viable edges that are non-linear,

Fig. 1. Wound prior to debridement.

∗ Corresponding author. Present address: 16 York Street, Harborne,Birmingham B17 0HG, UK. Tel.:+44-79858420149/1214272546.E-mail address: gper11@aol.com (G. Pereira).

that need to be debrided to obtain a smooth linear edge[4]. This can be technically difficult. We describe a simpletechnique to obtain linear skin edges during skin wounddebridement.

0020-1383/$ – see front matter © 2003 Elsevier Science Ltd. All rights reserved.doi:10.1016/S0020-1383(03)00064-0

G. Pereira, C. Pereira / Injury, Int. J. Care Injured 34 (2003) 954–956 955

2. Technique

A length of the non-viable skin edge to be excised isheld between the blades of a dissecting forceps, preferablya toothed forceps such as a Gilles’ forceps (Fig. 1). The

Fig. 2. Wound debridement technique using dissecting forceps.

Fig. 3. Neat, linear skin edge obtained, after debridement.

scalpel blade is then slid over the near side of the forceps(the opposite side of the free edge of the skin), excising theunwanted skin that now remains between the blades of theforceps (Fig. 2). Skin edges thus obtained are more linearthan those obtained by conventional techniques (Fig. 3).

956 G. Pereira, C. Pereira / Injury, Int. J. Care Injured 34 (2003) 954–956

3. Discussion

Surgical debridement of wounds is an essential step in themanagement of most traumatic wounds[1,2,4,9]. Linear skinedges are advocated in general teaching as well as standardtextbooks on operative technique, to achieve a good cosmeticscar[3,5–8].

In preparing a traumatic wound for suture, the woundedges that are appreciably damaged should be excised, soconverting it into a ‘clean’ wound, in an attempt to get a fi-nal result primarily. Edges to be approximated should havebeen cut in a clean line and at right angles to the skin surface.Ragged or angled edges should be trimmed since this sim-plifies closure and results in a linear scar. The objective ofskin closure is to approximate the cut edges so that they healrapidly without complications and leave a neat scar[3,5–7].

4. Conclusion

We illustrate a simple, reproducible method of skin edgedebridement, which is easy to teach and to learn, that resultsin a linear skin edge prior to closure.

References

[1] Attinger CE, Bulan EJ. Surgical debridement: the key tosuccessful wound healing and reconstruction. Clin Pediatr Med Surg2000;17(4):599–630.

[2] Attinger CE, Bulan EJ. Debridement: the key initial first step in woundhealing. Foot Ankle Clin 2001;6(4):627–60.

[3] Bently G, Geer RB. Rob and Smith’s operative surgery—orthopaedics.Lippincott: Williams & Wilkins; 1993. p. 2–3.

[4] Edlich RF, Rodeheaver GT, Thacker JG, Winn HR, Edgerton MT.Management of soft tissue injury. Clin Plastic Surg 1977;4(2):191–8.

[5] McGregor AD. Fundamental techniques of plastic surgery and theirsurgical applications, 10th ed. London: Churchill Livingstone; 2000.p. 8–9.

[6] Quick C, Thomas P. Principles of surgical management, first ed.Oxford: Oxford University Press; 2000. p. 220–1.

[7] Rintoul RF. Farquharson’s textbook of operative surgery, eighth ed.London: Churchill Livingstone; 1995. p. 165–6.

[8] Vowden KR, Vowden P. Wound debridement. Part 2. Sharp techniques.J Wound Care 1999;8(6):291–4.

[9] Wilson JL, Kocurek K, Doty BJ. A systematic approach to lacerationrepair: tricks to ensure the desired cosmetic result. Postgraduate Med2000;107(4):77–83.