Letter to the Editor

Closure of Round Cutaneous Postoperative Wounds with the Purse String Suture

Authors: Philip R. Cohen, MD, Paul T. Martinelli, MD, Keith E. Schulze, MD, Bruce R. Nelson, MD


The intradermal1–3 and cuticular4 purse string sutures are inexpensive, rapid procedures which are easily learned and can be useful for the complete1,2 or partial3,4 closure of cutaneous surgical wounds. They are especially suited for the repair of round, postoperative defects following local excision of a melanoma,2,4 nonmelanomatous skin cancer (such as basal cell carcinoma and squamous cell carcinoma),1,3,4 and benign cutaneous neoplasms.4 Indeed, the purse string suture is ideal for postsurgical wounds that are large and might otherwise necessitate either a skin graft with a resulting large donor site, a large local flap, or side-to-side closure with accompanying removal of extensive Burow triangles (Fig. 1A).5

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1. Romiti R, Randle HW. Complete closure by purse-string suture after Mohs micrographic surgery on thin, sun-damaged skin. Dermatol Surg 2002;28:1070–1072.
2. Mather MK, Harrington AC, Montemarano A, et al. Surgical pearl: purse string suture in the management of poorly delineated melanomas. J Am Acad Dermatol 1998;38:99–101.
3. Weisberg NK, Greenbaum SS. Revisiting the purse-string closure: some new methods and modifications. Dermatol Surg 2003;29:672–676.
4. Cohen PR, Martinelli PT, Schulze KE, et al. The cuticular purse string suture: a modified purse string suture for the partial closure of round postoperative wounds. Int J Dermatol, in press.
5. Cohen PR, Martinelli PT, Schulze KE. The purse string suture revisited: a useful technique for the closure of cutaneous surgical wounds. Int J Dermatol, in press.