Various Applications of Purse-String Suture and Its Cosmetic Outcome in Cutaneous Surgical Defects

Background: Purse-string suture is a simple technique to reduce wound size and to achieve complete or partial closure of skin defects. Objective: To classify situations in which purse-string sutures can be utilized and to assess the long-term size reduction and cosmetic outcome of the final scar. Methods: Patients (93 from Severance hospital and 12 from Gangnam Severance hospital) in whom purse-string sutures were used between January 2015 and December 2019 were retrospectively reviewed. Wound site, final reconstruction method, repair duration, final wound size, and Vancouver scar scale were assessed. Results: A total of 105 patients were reviewed. Lesions were located on the trunk (48 [45.7%]), limbs (32 [30.5%]), and face (25 [23.8%]). Mean ratio of wound length/primary defect length was 0.79 +/- 0.30. Multilayered purse-string suture showed the shortest duration from excision to final repair (p<0.001) and most effectively minimized the scar size (scar to defect size ratio 0.67 +/- 0.23, p=0.002). The average Vancouver scar scale measured at the latest followup visit at least 6 months postoperatively was 1.62, and the risk of hypertrophic scarring was 8.6%. There was no significant difference in the Vancouver scar scale and the risk of hypertrophic scarring between the different surgical method groups. Conclusion: Purse-string sutures can be utilized in many stages of reconstruction to effectively reduce scar size without compromising the final cosmetic outcome.

Automated summary

This study retrospectively reviewed patients who underwent purse-string sutures between January 2015 and December 2019. The results showed that multilayered purse-string suture had the shortest repair duration and effectively minimized the scar size. The average Vancouver scar scale measured at least 6 months postoperatively was 1.62, with a risk of hypertrophic scarring of 8.6%. There was no significant difference in scar assessment and risk of hypertrophic scarring between different surgical method groups.