08 | FINAL DESTINATION: THE PURSE-STRING CLOSURE

M. Crivellari, M. Venturini, P. Monari | Dermatology Department, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy

Introduction. Surgical excision remains the gold standard for treating skin epitheliomas, specifically basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Managing post-surgical defects, particularly in aesthetically sensitive areas or regions with limited skin laxity, often requires complex reconstructive techniques. The purse-string suture offers a simple and versatile alternative, capable of reducing the defect’s diameter and optimizing scarring outcomes.
Objectives. To evaluate the efficacy, safety, and aesthetic-functional outcomes of the purse-string closure in patients undergoing excision of skin epitheliomas.
Materials and Methods. Patients who underwent surgical excision of skin epitheliomas followed by purse-string closure at our center were evaluated. We analyzed the anatomical site, defect size, histological type, and the degree of diameter reduction achieved. Post-operative complications (infection, dehiscence, necrosis, recurrence), healing time, and aesthetic outcomes—assessed via a dedicated clinical scale (Vancouver Scar Scale) and patient satisfaction—were also recorded.
Results. The technique allowed for a significant reduction in surgical defect diameter, with most cases achieving primary intention healing. Complications were infrequent and minor. Aesthetic results were rated as good-to-excellent in the majority of patients, with high levels of reported satisfaction. No recurrences were observed during the follow-up period.
Conclusions. Purse-string closure is confirmed as an effective, safe, and easily reproducible technique for managing post-surgical defects. It represents a valid alternative to more complex reconstructive procedures in selected sites, allowing for reduced operative time and favorable aesthetic-functional results.