Technique to Reduce Wound Size: The Double-Opposing Purse-String and Horizontal Continuous Closure Algorithm.
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Surgical reconstruction of complex wounds requires considerable planning to ensure optimal patient outcomes. A conservative approach utilizing the lower tiers of the reconstructive ladder is preferred, especially in patients with comorbidities lending to a higher risk of poor wound healing. A simplified, low-risk solution with a double-opposing purse-string suture (PSS) and horizontal continuous closure technique may be particularly helpful in reducing the need for more complex techniques of wound reconstruction in select patient populations. Methods: A retrospective chart review was performed on all patients who underwent reconstruction with the double-opposing PSS technique (N = 57) by the senior author (B.J.W.) at the University of Louisville between 2019 and 2022. Results: (44) = 3.9, 95% CI). A total of 21 wounds required a skin graft, meaning 63% of the wounds were successfully closed without the use of skin graft as a result of the double-opposing PSS technique. In addition, of those 21 wounds, the skin grafts, as well as the donor site sizes, were smaller. Conclusions: This approach to wound closure demonstrates usefulness in reducing the size of or need for skin grafts in complex wound patients, particularly in those with comorbidities. The majority of patients underwent successful closure of their complex defects in various areas (eg, face, extremities) with this technique. Residual defects requiring skin graft allowed for a smaller graft and, thereby, donor site. Ultimately, this technique reduces the risk of complex complications by simplifying and reducing wound size.
Source: PubMed
Authors: Alexander L Mostovych, Lexina R Patel, Kartik Garg, Quinton L Carr, Mitchell Peake, Ryan Cantrell, Bradon J Wilhelmi
Institutions: University of Louisville, New York University
Language: English
Topic: Wound Healing and Treatments
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413050094