Surgical curettement, more commonly spelled curettage, is the removal of tissue from the body using a spoon-shaped instrument with a sharp edge called a curette. The curette scrapes or scoops tissue from a surface or cavity, and the technique is used across several medical specialties, from gynecology and dermatology to orthopedics and dentistry. Despite the range of applications, the core principle is always the same: a sharp-edged tool removes unwanted or abnormal tissue so the body can heal with healthy tissue in its place.
How the Procedure Works
A curette looks like a small spoon with sharpened edges. The surgeon inserts it into or against the target area and uses a controlled scraping motion to detach tissue from its underlying surface. In some cases, a suction-based curette replaces the traditional sharp instrument, pulling tissue away with vacuum pressure rather than scraping. The choice between sharp and suction curettage depends on the location, the type of tissue being removed, and the clinical goal. Recent guidance from the American College of Obstetricians and Gynecologists notes that the use of sharp curettage should be extremely limited, particularly in office settings, reflecting a broader shift toward gentler suction techniques where possible.
Uterine Curettage (D&C)
The most widely known form of curettage is dilation and curettage, or D&C, a gynecological procedure used to remove tissue from inside the uterus. “Dilation” refers to gently widening the cervix so that instruments can pass through. Once the cervix is open, a curette is inserted to scrape or suction out the uterine lining.
D&C serves both diagnostic and therapeutic purposes. Doctors use it to investigate unexplained bleeding, collect tissue samples for biopsy, or remove retained tissue after a miscarriage or delivery. Suction curettes have become increasingly common for this procedure and may actually detect endometrial abnormalities at higher rates than traditional sharp curettage.
Most D&C procedures take place in a hospital or surgical center under general anesthesia or deep sedation. In one institutional review, about 72% of patients received general anesthesia while 28% had deep sedation. Patients who had the procedure in a labor and delivery suite were more likely to receive sedation rather than full general anesthesia. Blood loss tends to be lower with sedation-based approaches compared to general anesthesia with a breathing tube, with one study finding average blood loss of roughly 88 mL under sedation versus 290 mL under general anesthesia.
Uterine Scarring Risk
The most significant long-term risk of uterine curettage is the formation of scar tissue inside the uterus, a condition called Asherman syndrome. The risk varies substantially depending on timing and circumstances. For a first-trimester procedure, intrauterine scarring develops in up to 13% of cases. That number climbs to around 30% when D&C is performed after a late miscarriage, and can reach 23% when a repeat procedure is done two to four weeks after the initial one. These numbers are one reason clinicians now favor hysteroscopic methods (using a tiny camera to guide precise tissue removal) over blind curettage when the option is available, since hysteroscopy is associated with lower rates of adhesion formation.
Skin Curettage
In dermatology, curettage is a frontline treatment for certain skin cancers and precancerous growths. The procedure is typically paired with electrodesiccation, a technique that uses an electric current to destroy remaining abnormal cells and seal the wound. Together, the combination is called ED&C (electrodesiccation and curettage).
ED&C is most commonly used for non-melanoma skin cancers, specifically basal cell carcinoma and squamous cell carcinoma. For appropriately selected tumors, the cure rate exceeds 95%. The wound is left to heal on its own rather than being stitched closed, a process called secondary intention healing. This typically results in a flat, pale scar over several weeks.
One tradeoff to consider is recurrence. A study comparing curettage with cryosurgery (freezing) against standard surgical excision for basal cell carcinoma found a five-year recurrence rate of about 20% for the curettage group versus 8% for surgical excision. The difference was not statistically significant in that particular study, but it illustrates why excision is generally preferred for higher-risk or recurrent tumors, while curettage works well for smaller, superficial ones in low-risk locations.
Bone Tumor Curettage
Orthopedic surgeons use curettage to treat benign bone tumors and cysts, most notably giant cell tumors. Rather than removing an entire section of bone, the surgeon opens a window in the bone’s hard outer shell, scoops out the tumor contents with curettes, and then cleans and treats the resulting cavity.
After the tumor is removed, the cavity is washed repeatedly with hydrogen peroxide and saline. Chemical agents like phenol or physical treatments such as liquid nitrogen or argon beam cauterization are applied to the cavity walls to kill any remaining tumor cells. The empty space is then packed with bone graft material or bone cement to restore structural support. This approach preserves the limb’s function and avoids the more drastic step of removing a large segment of bone, making it the preferred treatment for most cases that haven’t broken through the bone’s outer surface extensively.
Dental and Periodontal Curettage
In dentistry, curettage refers to scraping diseased soft tissue from the inner wall of a gum pocket around a tooth. It is closely related to scaling and root planing, the deep-cleaning procedures used to treat gum disease. Scaling removes tartar and bacteria from tooth surfaces and below the gumline, while root planing smooths the root surface to prevent further buildup and help gums reattach to the tooth.
For advanced gum disease that doesn’t respond to these less invasive approaches, surgical options like flap surgery become necessary. In flap surgery, the gum tissue is folded back to expose the roots for more thorough cleaning and to allow reshaping of damaged bone before the tissue is stitched back into place.
Recovery After Curettage
Healing timelines depend heavily on the type of curettage performed and where on the body it takes place.
For gum curettage, the tissue goes through a predictable sequence. Immediately after the procedure, gums appear red and bleed easily. After one week, the gum margin shifts slightly and the redness begins to fade. By two weeks, color, texture, and contour typically return to normal, and the tissue is well-adapted to the tooth again. Tooth looseness may increase right after treatment but usually improves within one to two weeks, often reaching better stability than before the procedure.
For skin curettage, wounds left to heal by secondary intention generally take several weeks to fully close, depending on size and location. Keeping the wound clean and moist with a bandage promotes faster healing and a better cosmetic result.
After a D&C, most people can return to normal activities within a day or two. Cramping and light bleeding are common for several days. Physical recovery is relatively quick, but the uterine lining takes a few weeks to fully regenerate. Your doctor will typically advise avoiding intercourse and tampon use for a period after the procedure to reduce infection risk.
Anesthesia and What to Expect
The type of anesthesia varies by procedure. Skin curettage is almost always done under local anesthesia, meaning you’re awake but the area is numb. Bone tumor curettage requires regional or general anesthesia since it involves opening bone. For D&C, the approach ranges from local anesthesia with sedation to full general anesthesia, depending on the clinical setting, the reason for the procedure, and patient preference.
Regardless of the specific application, curettage is generally a short procedure. Skin curettage takes minutes. A D&C typically takes 15 to 30 minutes. Bone curettage is longer and more involved but is still considered a limb-sparing, relatively conservative surgery compared to the alternatives. In all cases, the removed tissue is often sent to a lab for examination, giving your doctor important diagnostic information alongside the therapeutic benefit of the procedure itself.