Purse string suture

AMA Citation The Purse-String Suture. In: Kantor J. Kantor J(Ed.), Ed. Jonathan Kantor.eds. Atlas of Suturing Techniques: Approaches to Surgical Wound, Laceration, and Cosmetic Repair. McGraw Hill; 2017. Accessed June 18, 2023. https://accessemergencymedicine.mhmedical.com/content.aspx?bookid=2076§ionid=156455272 This technique is designed to either shrink the size of a defect or obviate it entirely, depending on the degree of tension and the size of the defect. It is a niche technique, since the purse-string effect tends to lead to a slight puckering in the surrounding skin, a feature that may be acceptable (and will likely resolve with time) on areas such as the forearms and back but is less desirable in cosmetically sensitive locations such as the face. The running nature of the technique means that compromise at any point in the course of suture placement may result in wound dehiscence, though for this reason a larger gauge suture material is generally utilized. Suture choice is dependent in large part on location, though as always the smallest gauge suture material appropriate for the anatomic location should be utilized. On the back and shoulders, 2-0 or 3-0 nonabsorbable suture material is effective, and on the extremities and scalp, a 3-0 or 4-0 absorbable suture material may be used. Since the technique requires easy pull through of suture material, monofilament nonabsorbable suture is generally preferable. • The wound edges are broadly undermined. • With the ...

Rectal Prolapse Rectal prolapse is a sign, not a disease. Some of the underlying etiologies include intestinal parasitism, chronic diarrhea, dystocia, or any disease-causing chronic tenesmus, stranguria, or abdominal pressing. Diagnosis is made by visual observation of a red tube-like protrusion of rectal mucosa. Rectal prolapse must be differentiated from a prolapsed intussusception. The differential diagnosis of rectal prolapse and prolapsed intussusception can be done by placing a finger or blunt instrument such as a thermometer between the prolapsed mucosa and mucocutaneous junction. If resistance is met, the diagnosis is rectal prolapse. If the finger or instrument is easily passed, a prolapsed intussusception is diagnosed. Rectal prolapse can be managed by several methods including reduction and purse-string suture, amputation, or colopexy. The technique selected depends upon viability of the prolapsed tissue, size and reducibility of the prolapse, and recurrence after a previous technique has failed. In small animal practice, patients with rectal prolapse are generally presented early; before significant mucosal necrosis occurs. Therefore, initial management generally involves reduction and placement of a purse-string suture. This is accomplished by general anesthesia, application of 50% dextrose to reduce mucosal edema, gentle reduction of the prolapsed tissue, and placement of a purse-string suture shows the typical appearance of a rectal prolapse. This suture is ...

The Woggle technique is the purse-string suture modified using to close a puncture site after a percutaneous procedure. Techniques common to all procedure include: • a purse-string suture is done around the introducer sheath (the short plastic tube placed within a vein or artery) • cut the needle off the suture and insert the two free ends of the suture through the tension collar (known as the Woggle device) • remove the sheath out slowly while tightening the tension collar to achieve hemostasis • the stopcock is then turn off to lock the suture After a half of hour, one of the sutures can be cut very close to the skin and the suture removed.

What Is Rectal and Anal Prolapse in Dogs? Rectal prolapse in dogs is a condition in which rectal tissue protrudes through the anus. It’s usually caused when your dog repeatedly strains while pooping or peeing. There are two types of prolapse: • Partial Prolapse: Only a small portion of the anal and/or rectal tissue is visible as it protrudes through the anus. This small portion may only be visible while your dog is straining, then spontaneously returns to its normal position inside the rectum. • Complete Prolapse: All the anal tissue and some of the rectal tissue and lining protrude from the anus, even when your dog is not straining. This tissue does not return spontaneously to its normal position. Prolapsed tissue will often appear bright red in color, and it may look like a swollen tube because it’s filled with fluid. If prolapse is not treated, over time it may develop into a complete prolapse, and the tissue may dry out and turn a dark color—usually blue or black. This means the blood supply to the tissue is obstructed and the tissue itself may be dying. Symptoms of Rectal and Anal Prolapse in Dogs Dogs with rectal prolapse typically hunch over while straining to poop or pee. While they’re straining, you may see a tube-shaped mass of tissue protruding through the anal opening. In a partial anal prolapse, the exposed tissue may go back to its normal position after your dog stops straining. In a complete anal prolapse, tissue will usually not go back to its normal positi...

Background Purse-string suture is a simple technique that can be used to reduce the surface area of circular wounds in an effort to obtain minimal scarring. In this report, we provide evidence of the effectiveness of the purse-string suture as a stand-alone procedure that allows a permanent primary complete closure of small to moderate skin defects. The procedure is used primarily for the repair of skin defects due to cutaneous tumor excision in older patients. Methods The purse-string suture is executed by using a 1-0 absorbable suture, always by exiting and reentering intradermally and never penetrating the epidermis, in a circumferential fashion. Results The immediate postoperative folds flatten in about a 4-week postoperative time span, and the resulting scar is the smallest obtainable. Conclusions The round block purse-string suture is a simple technique which allows complete closure of skin defects without importing tissue from a distance, and it can be particularly suitable for older patients because of their skin laxity. Illustration depicting steps in the purse-string procedure. (A) Round skin markings for surgical excision of the lesion. (B) Intradermal positioning of the purse-string suture in a circumferential fashion. (C) and (D) The suture was pulled and gently tied to obtain complete closure of the skin defect. Operative photographs of our patient, a 65-year-old woman with a basal cell carcinoma of the left paranasal cheek (1.6 cm diameter). (A) Round surgic...

Background Purse-string suture is a simple technique that can be used to reduce the surface area of circular wounds in an effort to obtain minimal scarring. In this report, we provide evidence of the effectiveness of the purse-string suture as a stand-alone procedure that allows a permanent primary complete closure of small to moderate skin defects. The procedure is used primarily for the repair of skin defects due to cutaneous tumor excision in older patients. Methods The purse-string suture is executed by using a 1-0 absorbable suture, always by exiting and reentering intradermally and never penetrating the epidermis, in a circumferential fashion. Results The immediate postoperative folds flatten in about a 4-week postoperative time span, and the resulting scar is the smallest obtainable. Conclusions The round block purse-string suture is a simple technique which allows complete closure of skin defects without importing tissue from a distance, and it can be particularly suitable for older patients because of their skin laxity. Illustration depicting steps in the purse-string procedure. (A) Round skin markings for surgical excision of the lesion. (B) Intradermal positioning of the purse-string suture in a circumferential fashion. (C) and (D) The suture was pulled and gently tied to obtain complete closure of the skin defect. Operative photographs of our patient, a 65-year-old woman with a basal cell carcinoma of the left paranasal cheek (1.6 cm diameter). (A) Round surgic...

The Woggle technique is the purse-string suture modified using to close a puncture site after a percutaneous procedure. Techniques common to all procedure include: • a purse-string suture is done around the introducer sheath (the short plastic tube placed within a vein or artery) • cut the needle off the suture and insert the two free ends of the suture through the tension collar (known as the Woggle device) • remove the sheath out slowly while tightening the tension collar to achieve hemostasis • the stopcock is then turn off to lock the suture After a half of hour, one of the sutures can be cut very close to the skin and the suture removed.

Rectal Prolapse Rectal prolapse is a sign, not a disease. Some of the underlying etiologies include intestinal parasitism, chronic diarrhea, dystocia, or any disease-causing chronic tenesmus, stranguria, or abdominal pressing. Diagnosis is made by visual observation of a red tube-like protrusion of rectal mucosa. Rectal prolapse must be differentiated from a prolapsed intussusception. The differential diagnosis of rectal prolapse and prolapsed intussusception can be done by placing a finger or blunt instrument such as a thermometer between the prolapsed mucosa and mucocutaneous junction. If resistance is met, the diagnosis is rectal prolapse. If the finger or instrument is easily passed, a prolapsed intussusception is diagnosed. Rectal prolapse can be managed by several methods including reduction and purse-string suture, amputation, or colopexy. The technique selected depends upon viability of the prolapsed tissue, size and reducibility of the prolapse, and recurrence after a previous technique has failed. In small animal practice, patients with rectal prolapse are generally presented early; before significant mucosal necrosis occurs. Therefore, initial management generally involves reduction and placement of a purse-string suture. This is accomplished by general anesthesia, application of 50% dextrose to reduce mucosal edema, gentle reduction of the prolapsed tissue, and placement of a purse-string suture shows the typical appearance of a rectal prolapse. This suture is ...

What Is Rectal and Anal Prolapse in Dogs? Rectal prolapse in dogs is a condition in which rectal tissue protrudes through the anus. It’s usually caused when your dog repeatedly strains while pooping or peeing. There are two types of prolapse: • Partial Prolapse: Only a small portion of the anal and/or rectal tissue is visible as it protrudes through the anus. This small portion may only be visible while your dog is straining, then spontaneously returns to its normal position inside the rectum. • Complete Prolapse: All the anal tissue and some of the rectal tissue and lining protrude from the anus, even when your dog is not straining. This tissue does not return spontaneously to its normal position. Prolapsed tissue will often appear bright red in color, and it may look like a swollen tube because it’s filled with fluid. If prolapse is not treated, over time it may develop into a complete prolapse, and the tissue may dry out and turn a dark color—usually blue or black. This means the blood supply to the tissue is obstructed and the tissue itself may be dying. Symptoms of Rectal and Anal Prolapse in Dogs Dogs with rectal prolapse typically hunch over while straining to poop or pee. While they’re straining, you may see a tube-shaped mass of tissue protruding through the anal opening. In a partial anal prolapse, the exposed tissue may go back to its normal position after your dog stops straining. In a complete anal prolapse, tissue will usually not go back to its normal positi...

AMA Citation The Purse-String Suture. In: Kantor J. Kantor J(Ed.), Ed. Jonathan Kantor.eds. Atlas of Suturing Techniques: Approaches to Surgical Wound, Laceration, and Cosmetic Repair. McGraw Hill; 2017. Accessed June 18, 2023. https://accessemergencymedicine.mhmedical.com/content.aspx?bookid=2076§ionid=156455272 This technique is designed to either shrink the size of a defect or obviate it entirely, depending on the degree of tension and the size of the defect. It is a niche technique, since the purse-string effect tends to lead to a slight puckering in the surrounding skin, a feature that may be acceptable (and will likely resolve with time) on areas such as the forearms and back but is less desirable in cosmetically sensitive locations such as the face. The running nature of the technique means that compromise at any point in the course of suture placement may result in wound dehiscence, though for this reason a larger gauge suture material is generally utilized. Suture choice is dependent in large part on location, though as always the smallest gauge suture material appropriate for the anatomic location should be utilized. On the back and shoulders, 2-0 or 3-0 nonabsorbable suture material is effective, and on the extremities and scalp, a 3-0 or 4-0 absorbable suture material may be used. Since the technique requires easy pull through of suture material, monofilament nonabsorbable suture is generally preferable. • The wound edges are broadly undermined. • With the ...