Collett Tolbin, Smith Andrea, Liu Yuan F, Bradford Benjamin, Yang Jin, Ardeshirpour Farhad, Inman Jared C
Departments of Otolaryngology, Head and Neck Surgery, and.
Dermatology, Loma Linda University Health, Loma Linda, California.
Dermatol Surg. 2019 Feb;45(2):216-222. doi: 10.1097/DSS.0000000000001700.
The purse-string suture (PSS) is a simple, reversible method for reconstructing skin cancer defects. Its utility may be underappreciated in head and neck reconstructive surgery.
To evaluate the utility of the PSS as an adjunct to the reconstructive ladder when reconstructing head and neck skin cancer defects.
This prospective nonrandomized cohort included 109 consecutive adult patients with head and neck defects resulting from skin cancer resection. The PSS was placed in every patient after resection. Patients were evaluated before and after suture placement, and final reconstructive methods were recorded.
The PSS resulted in a mean defect area reduction of 77.1% (p < .001) and was used in the final reconstruction in 79 (72.5%) patients. The PSS reduced the number of patients requiring adjacent tissue transfer (11), regional tissue transfer (3), and free tissue transfer (1) by 69.4%, 70%, and 80%, respectively. Fifty patients underwent reconstruction in the operating room. After intraoperative placement of the PSS, it was determined that 22 (44.0%) of these defects could have been reconstructed in the clinic (p = .003).
The PSS dramatically reduces defect size, simplifies reconstructive techniques, and often permits reconstruction to be performed in the clinic rather than the operating room.
荷包缝合术（PSS）是一种用于修复皮肤癌缺损的简单、可逆的方法。其在头颈部重建手术中的作用可能未得到充分认识。
评估荷包缝合术作为头颈部皮肤癌缺损重建时重建阶梯辅助方法的效用。
这项前瞻性非随机队列研究纳入了109例因皮肤癌切除导致头颈部缺损的成年患者。每位患者在切除术后均进行荷包缝合。在缝合前后对患者进行评估，并记录最终的重建方法。
荷包缝合术使缺损面积平均减少77.1%（p <.001），79例（72.5%）患者在最终重建中使用了该方法。荷包缝合术使需要进行邻位组织转移（11例）、区域组织转移（3例）和游离组织转移（1例）的患者数量分别减少了69.4%、70%和80%。50例患者在手术室进行了重建。在术中放置荷包缝合术后，确定其中22例（44.0%）缺损可在门诊进行重建（p =.003）。
荷包缝合术可显著减小缺损大小，简化重建技术，且通常能使重建在门诊而非手术室进行。
