Curettage

Curettage is a medical procedure in which tissue is scraped from a surface or cavity using a curette, a spoon-shaped instrument with a sharp edge. It is performed in several specialties, most commonly in obstetrics and gynecology, dermatology, and orthopedics. In gynecology, curettage often refers to dilation and curettage (D&C), where the cervix is dilated and the endometrium is scraped to obtain tissue for diagnosis or to remove tissue after pregnancy loss or abortion. Suction curettage, a related technique, uses suction to remove contents of the uterus and may be used for abortion or treatment of intrauterine bleeding.

In dermatology, cutaneous curettage involves scraping a skin lesion, such as a wart or seborrheic keratosis, with a small sharp curette. The lesion may be followed by cautery to destroy residual tissue and reduce recurrence. In orthopedics or maxillofacial surgery, curettage refers to scraping out lesions from bone or bone cavities, sometimes with removal of cystic material or soft tissue, often followed by grafting or filling.

Indications vary by site but commonly include diagnostic sampling (endometrial or skin tissue), removal of abnormal tissue, treatment of incomplete abortion, and management of certain skin lesions. The procedure is usually performed under local or regional anesthesia, with care to minimize bleeding and infection. Aftercare may involve pathology examination of the collected tissue and, in gynecologic cases, monitoring for complications such as infection, perforation, or intrauterine adhesions.

Risks include bleeding, infection, injury to surrounding structures, perforation, and scarring. Alternatives depend on the condition and may include medical management, more specialized surgical approaches (such as hysteroscopic guidance in uterine procedures), or observation.