Wound Management — SCE Dermatology MCQ

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ModerateWound HealingWound ManagementSCE Dermatology

A 50-year-old woman has a chronic non-healing wound. The wound edge shows epibole — a rolled, thickened wound edge where the epithelium has rolled under itself. This prevents epithelial cell migration across the wound. What intervention addresses epibole?

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Correct answer: D — Debridement of the rolled wound edge to stimulate fresh epithelial migration

Explanation lettering: C = shown as B · E = shown as C · B = shown as D · D = shown as E

The correct answer is B, debridement of the rolled wound edge to stimulate fresh epithelial migration. Epibole occurs when the epidermal edge rolls downward and keratinises, physically blocking keratinocytes from migrating horizontally across the wound bed, so the wound edge becomes stalled despite an otherwise healthy-looking wound base. Sharp, curette, or chemical (silver nitrate) debridement removes this non-viable, rolled margin and exposes a fresh, flat epithelial edge capable of resuming migration, which is a core principle of the wound edge (E) component of the TIME wound bed preparation framework used across UK tissue viability practice. Surgical debridement is regarded as a practical mainstay for addressing chronic, non-advancing wound margins such as epibole, even though comparative trial evidence between debridement methods is limited. Without addressing the mechanical barrier itself, no dressing or systemic treatment will restore edge advancement.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions