Delayed staged closure with repeated directional suturing of cutaneous defects
Stephen B Tucker1, Brian L Ransdell
1Department of Dermatology, University of Texas-Houston Medical School, and Baylor College of Medicine, Houston, Texas 77030, USA.
Background:
Postsurgical wound management is traditionally a choice between intraoperative surgical repair or healing by secondary intention. We describe a technique that combines intraoperative and postoperative surgical repair with granulation.
Objective:
Delayed closure with repeated directional suturing was evaluated as an alternative closure technique for large wounds.
Methods:
Sixty patients had surgical defects partially closed intraoperatively with postoperative staged closures over 2 to 4 weeks. Only those wounds that could not be closed intraoperatively without vascular compromise or anatomic disfigurement were treated.
Results:
All wounds were closed using skin from the same anatomic unit. Complications were minimal, and the results were acceptable to both the patients and the surgeon.
Conclusion:
Delayed closure with repeated directional suturing is a reasonable alternative when primary closure is not possible or when it would cause anatomic disfigurement.
