Clinical Utility of the Scooped Curette in Wound Debridement for Ulcer Management: A Prospective Observational Study

Abstract

Background and Objectives: Chronic non-healing wounds continue to represent a major challenge in surgical practice because of their prolonged course, associated morbidity, and financial burden on both patients and healthcare systems. Debridement remains a cornerstone in wound management; however, currently available methods possess notable limitations. Sharp surgical debridement requires considerable expertise and may inadvertently damage healthy tissue, while enzymatic methods are expensive and often slow in action. The scooped curette, a hand-held instrument with a concave cutting edge, offers a practical alternative by allowing controlled and selective removal of necrotic tissue through a scooping motion. This study was conducted to evaluate the effectiveness, safety, and clinical applicability of the scooped curette in the treatment of chronic ulcers of varied etiologies in a tertiary care surgical unit.
Methods: A prospective observational study was performed at Saveetha Medical College and Hospital over a period of 18 months. Sixty adult patients with chronic ulcers persisting for longer than four weeks were enrolled after obtaining institutional ethical approval and informed consent. Ulcers included diabetic foot ulcers, venous ulcers, pressure ulcers, and post-traumatic ulcers. Debridement was carried out using a sterilized Fox-pattern scooped curette under local anesthesia at baseline, week 2, and week 4. Outcome measures included wound surface area, Wound Bed Score (WBS), development of healthy granulation tissue, rate of complete epithelialization, pain assessment using the Visual Analogue Scale (VAS), and procedure-related complications. Statistical analysis was performed using IBM SPSS version 25.0.
Results: A marked reduction in wound size was observed during follow-up. Mean wound area decreased from 18.4 ± 6.2 cm² at baseline to 3.2 ± 2.1 cm² at week 8, corresponding to an overall reduction of 82.6% (p < 0.001). Mean Wound Bed Score improved significantly from 7.2 ± 2.1 to 13.6 ± 1.4 by the end of the study period. Healthy granulation tissue was observed in 88.3% of wounds by week 4, while complete epithelialization occurred in 73.3% of patients within eight weeks. Procedural pain remained mild, with an initial mean VAS score of 3.1 ± 0.9 that progressively declined during subsequent sessions. Minor adverse events such as transient peri-wound erythema and superficial bleeding occurred in 21.7% of participants and resolved without major intervention. No serious complications were encountered.
Conclusions: The scooped curette was found to be an effective, safe, and well-tolerated instrument for debridement of chronic ulcers of diverse etiologies. Its advantages include low cost, reusability, technical simplicity, and minimal complication rates, making it particularly suitable for routine wound care practice in resource-limited healthcare settings. The findings support its incorporation into standardized chronic wound management protocols.