A simple technique for the excision of cutaneous carcinoma: the round block purse-string suture
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WORLD JOURNAL OF SURGICAL ONCOLOGY
TECHNICAL INNOVATIONS
Open Access
A simple technique for the excision of cutaneous carcinoma: the round block purse-string suture Edoardo Raposio1,2*, Michele Antonacci1 and Giorgia Caruana1,2
Abstract Background: Purse-string suture is a simple technique that can be used to reduce the surface area of circular wounds in an effort to obtain minimal scarring. In this report, we provide evidence of the effectiveness of the purse-string suture as a stand-alone procedure that allows a permanent primary complete closure of small to moderate skin defects. The procedure is used primarily for the repair of skin defects due to cutaneous tumor excision in older patients. Methods: The purse-string suture is executed by using a 1-0 absorbable suture, always by exiting and reentering intradermally and never penetrating the epidermis, in a circumferential fashion. Results: The immediate postoperative folds flatten in about a 4-week postoperative time span, and the resulting scar is the smallest obtainable. Conclusions: The round block purse-string suture is a simple technique which allows complete closure of skin defects without importing tissue from a distance, and it can be particularly suitable for older patients because of their skin laxity. Keywords: Dermatologic surgery, Purse-string suture, Reconstructive surgery, Round block suture, Surgical oncology
Background The purse-string suture was first described in dermatologic surgery by Peled et al. [1]. It is a simple technique that can be used to reduce the surface area of circular wounds in an effort to obtain minimal scarring. Its use over the years has been associated with other techniques. Brady et al. [2] performed the purse-string suture to reduce both the longitudinal and transverse dimensions of the wound so that they could place a small skin graft to complete the reconstruction. Ciatti and Greenbaum [3] described the use of the purse-string suture in combination with side-to-side bilateral adjacent tissue transfer. Using this procedure, they succeeded in closing or reducing large facial defects. Lin and Li [4] described use of a double-purse-string suture as an adjunct to conventional vertical sutures. Cohen et al. [5] and Zhu et al. [6] described using a similar suture to achieve partial closure of cutaneous defects as an adjunct to extensive undermining. * Correspondence: [email protected] 1 Department of Surgical Sciences, Plastic Surgeon Division, University of Parma, Via Gramsci 14, 43126 Parma, Italy 2 Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Via Gramsci, 43126 Parma, Italy
In this report, we propose the use of the purse-string suture as a stand-alone procedure that allows permanent primary complete closure of small to moderate skin defects, especially when side-to-side closure is not recommended due to a poor tissue laxity or epidermal thinning.
Methods After circular skin marking (Figure 1A), we performed, while the patient was under local anesthesia, a round sur
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