Park Sujin, Oh Yeongjoo, Lee Jong Won, Choi Sooyie, Nam Kyoung Ae, Roh Mi Ryung, Chung Kee Yang
Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Dermatology, Yongin Severance Hospital, Yongin, Korea.
Ann Dermatol. 2023 Apr;35(2):100-106. doi: 10.5021/ad.21.263.
Purse-string suture is a simple technique to reduce wound size and to achieve complete or partial closure of skin defects.
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.
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.
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 (<0.001) and most effectively minimized the scar size (scar to defect size ratio 0.67±0.23, =0.002). The average Vancouver scar scale measured at the latest follow-up 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.
Purse-string sutures can be utilized in many stages of reconstruction to effectively reduce scar size without compromising the final cosmetic outcome.
荷包缝合是一种简单的技术，可缩小伤口大小并实现皮肤缺损的完全或部分闭合。
对可使用荷包缝合的情况进行分类，并评估最终瘢痕的长期尺寸缩小情况和美容效果。
回顾性分析2015年1月至2019年12月期间使用荷包缝合的患者（首尔延世大学Severance医院93例，江南Severance医院12例）。评估伤口部位、最终重建方法、修复持续时间、最终伤口大小和温哥华瘢痕量表。
共纳入105例患者。病变位于躯干（48例[45.7%]）、四肢（32例[30.5%]）和面部（25例[23.8%]）。伤口长度/原始缺损长度的平均比值为0.79±0.30。多层荷包缝合从切除到最终修复的时间最短（<0.001），且最有效地缩小了瘢痕大小（瘢痕与缺损大小的比值为0.67±0.23，P=0.002）。术后至少6个月的最新随访时测得的温哥华瘢痕量表平均分为1.62，肥厚性瘢痕形成的风险为8.6%。不同手术方法组之间的温哥华瘢痕量表和肥厚性瘢痕形成风险无显著差异。
荷包缝合可用于重建的多个阶段，以有效缩小瘢痕大小，而不影响最终的美容效果。
