New application of purse string suture in skin cancer surgery

Abstract

Closure of large wounds may require full-thickness skin grafts, but their use is burdened by donor tissue availability and morbidity; the use of the purse string technique is an elegant way to overcome this problem. The study highlights the gain in terms of graft donor site morbidity and oncological radicality. The study included a group of 47 patients who underwent surgical excision for skin cancer and whose wounds were covered using a purse string suture and a skin graft. Radius of the defect left was measured after the lesion's excision and after the purse string suture. Thereafter, the difference between the initial defect area and the area after purse string suture was calculated. Initial defects ranged from 3.85 to 61.5 cm . After skin graft, the purse string suture ranged between 2.2 and 40 cm (mean area = 14 cm ). Gained area before the graft measured from 1.3 to 21.5 cm (mean gained area = 7.1 cm ). Average reduction was 33%. The technique allows a reduction of the size of the area to be grafted and the skin graft donor area, thus increasing the possibility of the feasibility of full-thickness grafts. In addition, it allows an optimal observation both of the area of tumour excision and margins during follow-up controls.

Purse‐string suture versus full‐thickness skin graft : An efficacy and safety comparison study

“…To the best of our knowledge, this is the first study that compares the efficacy and usefulness of the two different surgical techniques (PSS vs FTSG) in the closure of surgical defects in nondistensible areas, even if numerous previous studies reported PSS as a useful procedure to reduce the residual surgical area, needing a smaller size skin graft. [1][2][3]12 In our experience, the PSS technique proved to be a quick and easy procedure to close or approximate cutaneous skin defects after NMSC excision. Operative times were significantly reduced compared to those needed for FTSG, without perioperative adverse events and excellent hemostatic control, 13 even if the PSS requires a waiting time before removing the suture greater than FTSG.…”

“…In our study, patients underwent to PSS as a unique surgical procedure, and the potential residual defect was closed only by second intention, thus allowing to avoid a further central graft. To the best of our knowledge, this is the first study that compares the efficacy and usefulness of the two different surgical techniques (PSS vs FTSG) in the closure of surgical defects in non‐distensible areas, even if numerous previous studies reported PSS as a useful procedure to reduce the residual surgical area, needing a smaller size skin graft 1‐3,12 …”

Nasal Reconstruction With Two Stages Versus Three Stages Forehead Fap: What is Better for Patients With High Vascular Risk?

“…A maximal blood supply, a thin covering flap, and controlled contouring are ensured with this technique. [24][25][26][27][28][29] A disadvantage of this technique is the additional operative time but it is completely compensated for by an improved aesthetic outcome and by a reduced need for revisions at a later date. In fact, all patients who underwent nasal reconstruction using the 3-stage technique were satisfied to a higher degree than patients who underwent the 2-stage technique.…”

Deep sternal wound infection following cardiac surgery: A comparison of the monolateral with the bilateral pectoralis major flaps

“…This choice is associated with mortality rate between 5% and 80% . In the last years, radical debridement with the use of vascularized flaps reduced the mortality rate to 4.8% to 10.5%: in the most cases Pectoralis Major, Rectus Abdominis, and Latissimus Dorsi muscle flaps represent the main choices for SWIs surgical coverage and infection control. Nowadays, NPT is an accepted method for the treatment of open contaminated/infected‐acute/chronic wounds.…”