Case Study of Fabric-Based Brush Curette for Toe and Foot Crevice Wound Debridement and Tissue Sampling

IntroductionThe aim of the study was to demonstrate the effectiveness, ease of use, functionality in a case involving debridement of the toe(s) using a novel FDA compliant sterile single-use disposable brush-curette (Soft K-Rette®) utilizing a proprietary Kylon® medical fabric, capable to both debride and biopsy-sample chronic wounds.

Methods: This is a single case report of a patient with a chronic wound under the fourth toe that required both superficial and mechanical debridement of a wound apparent on the skin surface crevice(s). A paddle shaped device with an array of nylon stiff hooks serving as curettes and biopsy brush samplers was used to clean, mechanically debride, and excise different tissue types within the wound ranging from slough to semi-solid necrotic tissue.

Results: The fabric-based curette device with the paddle parallel to the handle deployed in a paint brush like motion provided a hygienic effect scraping free surface debris. When pressed more firmly and used in a rotational motion for mechanical debridement, it easily dislodged and removed necrotic surface tissue and slough completely and efficiently (rapidly) with minimal to no discomfort for the subject patient. The twisting motion could be excisional as the fabric tip functions as a curette as well but will not excise solid tissue, which would usually require sharp debridement (1). When necessary, a second sterile fabric based hooked brush array can trap tissue specimens suitable for histologic, molecular, or microbiologic evaluation.

Discussion: A novel minimally invasive approach to cleaning, mechanical or excisional debridement of non-solid wound tissue in crevice areas of the body including the toes/digits and inter-digit area is demonstrated. The hook array will trap biopsy tissue for anatomic pathology or molecular/culture analysis. It deserves more study in comparison to other debridement or tissue collection technology.