"Soap Scrap" Technique: A Tissue-Preserving Approach to Treating Wounds With Undermining or Pockets.

Abstract

The case series aims to introduce a novel tissue-preserving approach to treat complicated wounds with undermined edges or wounds with pockets. Wounds with undermining and wounds with pockets are commonly encountered in clinical practice and can be difficult to manage when trying to achieve wound closure. Traditionally, epibolic edges need to be resected or cauterized with silver nitrate, whereas, wound undermining or pockets need to be resected or unroofed. This case series evaluates the use of this novel tissue-preserving approach to the treatment of undermined areas and wound pockets.This method consists of three components: sharp debridement of all undermined areas or inside walls of wound pockets, compression, and immobilization. Compression can be performed using multilayered compression alone, modified negative pressure therapy (NPWT), or both. Immobilization of all wound layers can be achieved using a brace, removable Cam Walker, or a cast.This is a retrospective case series. This article present 11 patients with unfavorable wounds due to undermined areas or wound pockets who were treated using this methodology. The average patient age was 73 years old, including wounds of the upper and lower extremities. The average wound depth was 1.12 cm. The average undermined area was 1.7 cm, undermined areas ranging from 0.2 to 5 cm. Wounds healed on average in 9.1 weeks; all wounds healed between 3 to 15 weeks. This series demonstrates a novel tissue-preserving approach to treating wounds with undermining or wounds with pockets using debridement, immobilization, and compression.