Presuturing: A simple technique for excision of large skin lesions

Abstract

SOLUTION A simple and reliable way to reduce the number of staged excisions and risk of wound dehiscence is the so-called presuturing technique (Figs 1, A and 2, A). Under local anesthesia, multiple nonresorbable sutures (eg, with Ethilon) are placed across the lesion, pulling the edges and folding the adjacent skin over the area that is to be excised (Figs 1, B and 2, B). The sutures should be placed at least 24 hours up to 5 days before excision. The principle behind this technique is the stretching of adjacent skin beyond its inherent extensibility to reach sufficient skin laxity. Thus, reduction of the number of staged excisions or a complete 1-stage excision of the lesion with a standard primary closure technique can be achieved.