Secondary Intention Healing and Purse-String Closures

Dermatol Surg. 2015 Oct:41 Suppl 10:S178-86. doi: 10.1097/DSS.0000000000000480.

Abstract

Background: Secondary intention healing and purse-string closures are simple but extremely useful methods for the dermatologic surgeon to master.

Objective: To review the literature on the use of these two types of closures and offer recommendations based on our collective experiences.

Methods: A literature review was performed using the terms "secondary intention healing" and "purse-string closure." The evidence and recommendations from the resultant references were summarized in our article and synthesized with our own experiences.

Results: Twenty-eight sources were cited overall with fifteen related to secondary intention healing, eleven pertaining to purse-string closures, and one randomized, blind clinical trial comparing the two modalities.

Conclusion: The art of dermatologic surgery often requires a tailored approach to the patient and can involve a spectrum of closures, from the simplest to most complex. This variety not only provides more reconstruction options, but are also necessary to keep dermatologic surgery cost-effective. Certain locations or situations are more amenable for these two types of closures than others. The use of secondary intention healing, either alone or in conjunction with purse-string closures, should be in every dermatologic surgeon's armamentarium.

Publication types

  • Review

MeSH terms

  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / surgery
  • Dermatologic Surgical Procedures / methods*
  • Evidence-Based Medicine
  • Humans
  • Mohs Surgery / methods*
  • Patient Satisfaction
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Skin Diseases / surgery*
  • Skin Neoplasms / surgery
  • Suture Techniques*
  • Treatment Outcome
  • Wound Healing*