In medicine, the term cheesewiring or cheesewire effect (used interchangeably) describes any process in which cells or intercellular matrix are dissected or extruded either by the material being pressed through a taut element, or by the tension of a taut element pulling through tissue.
Examples include tumor growth penetrating the openings in a bowel stent that was placed to open an obstructed bowel,[1] sutures used to hold a transplanted cornea in place,[2] and treatment of tendon rupture, when sutures pull through the tendon.
Postoperatively as wound margins begin to swell, a suture can drag through the thin portion of tissue present near the surface.
It is apparent that cheesewiring has occurred if the suture has moved a little closer to the insertion site.
[4] Cheesewire complications are most often seen in cornea surgeries due to the soft tissue present in the eye.
The scar tissue fixes the tube in place and prevents the movement in the canalicular system with each blink creating problems.
Monofilament sutures create less drag while passing through tissue, but may decrease tensile strength and cause crimping.
Examples of cheesewiring used intentionally include treating fistulas, use in trabeculectomies, and to aid in endovascular aortic repair.
[5] In this procedure, a triangular partial thickness scleral flap is created using a diamond knife.
The cheesewire technique can be used to fenestrate an intimal flap, alleviating malperfusion in aortic dissection.
Pulling both ends of a guide wire in a caudally sawing motion down through the infrarenal neck and into the aneurysm sac completes the technique.