A suture may be more commonly known to the medical layperson as a stitch or stitches. These are actual stitches, like sewing, using a variety of materials and fibers that can be employed to close wounds. A number of wound closure techniques exist, and what type is preferred can vary by surgeon preference and area being stitched. In some instances, a certain type of stitch called a purse-string suture is indicated.
The basic technique for performing a purse-string suture is to stitch in a circle around a wound or open part of the body that needs closure. Once the circle is completed the two ends of the suture material are pulled together to cause skin, organs or other stitched areas to close. Sometimes a surgeon could create two circles with this suture technique, and this might cause the open area that requires closure to invert on itself, which can create a tighter and more secure closing. The analogy to a purse is simple to understand when people think of a drawstring purse than can be pulled together with a single string threaded through the top of the purse.
There are many times when purse-string suture is preferred in a surgery. It may be most applicable when people are closing a hollow organ or any form of round wound or defect. Sometimes this form of suturing is used to repair minor defects in the heart like an open patent ductus, but it may be particularly indicated for bowel surgery and to close openings left when an organ like the appendix is removed.
This form of suturing could have fewer applications on the skin’s surface because the closure could result in skin not being evenly placed together. This might mean greater scarring. On the other hand, there are some doctors who advocate for its use when removing benign skin cancers and cite reasonable results in appearance for patients after removal. Location on the body could make a difference, and it’s unlikely a purse-string suture would be used on the face after removal of a large skin cancer.
The purse-string suture is one of many types of sutures that might be used to close a wound and it illustrates the great diversity that exists in wound closure options. Sometimes, even large surgical wounds are not closed with any form of stitches and doctors opt for other closure techniques with surgical staples or surgical glue. However for round wounds, and in a variety of other instances, this technique may be most appropriate.
