See an example at the Skincancerclinic blog on Friday 13th April.
The purse-string suture revisited: a useful technique for the closure of cutaneous surgical wounds
Philip R. Cohen, MD, Paul T. Martinelli, MD, Keith E. Schulze, MD, and Bruce R. Nelson, MDFrom the Dermatologic Surgery Center of Houston, Houston, Texas and Department of Dermatology, University of Texas-Houston Medical School, Houston, Texas
Correspondence Philip R. Cohen, MD 805 Anderson Street Bellaire, TX 77401-2806 E-mail: mitehead@aol.com
Reprints request to: Bruce R. Nelson, MD Dermatologic Surgery Center of Houston, PA 6655 Travis, Suite 840 Houston, TX 77030 bnelson@dermsurgeryhouston.com

Abstract

The purse-string suture provides complete or partial closure of round postoperative skin defects. It is a rapid and simple procedure to perform. Tension placed on the suture uniformly advances the skin from the entire periphery of the wound, resulting in a significant reduction of the defect size and enhancement of hemostasis at the wound edge. The history, modifications of the technique, advantages, and potential complications of the purse-string suture are reviewed. It is not only useful following the removal of nonmelanoma skin cancer but also after the local excision of melanoma. In addition, this technique is especially suitable for the repair of round surgical wounds for patients who are unable to modify their active lifestyles during the week following surgery, individuals concurrently being treated with anticoagulants, antiplatelet agents or both, and people with extensive postoperative defects that would otherwise require either a skin graft or a large cutaneous flap. Typically, the site of the surgical wound following partial or complete closure with the purse-string suture demonstrates excellent long-term cosmetic and functional results.