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What is a Purse-String Suture?
Tricia Christensen
Tricia Christensen
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.
Tricia Christensen
Tricia has a Literature degree from Sonoma State University and has been a frequent TheHealthBoard contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.
Learn more...
Tricia Christensen
Tricia has a Literature degree from Sonoma State University and has been a frequent TheHealthBoard contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.
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![A purse-string suture is often preferred in a surgery.]()
By: dacasdoA purse-string suture is often preferred in a surgery. -
![Equipment used to place and remove purse-string sutures.]()
By: Katerina AmchentsevaEquipment used to place and remove purse-string sutures. -
![Medical school students may be tasked with practicing suture techniques, including purse-string stitches.]()
By: Sherry YatesMedical school students may be tasked with practicing suture techniques, including purse-string stitches. -
![Minor defects in the heart can sometimes be repaired with a purse-string suture.]()
By: OlexandrMinor defects in the heart can sometimes be repaired with a purse-string suture.
Discussion Comments
@ddljohn: I am happy to find your post regarding purse string sutures in eye operations. I am almost sure that your father had previous Radial Keratotomy as eye surgery and that type of refractive eye surgery caused him late complications.
As a 43 year old Hungarian male I suffer currently with the same vision problems. I would like to ask more about your father's condition and operation.
@turkay-- I know about that kind of breast reconstruction surgery. I've also been wanting to get it because I'm in the same situation as your sister. But my doctor is not a fan of it and I can't seem to find a doctor in my area who does it.
The main reason that I want purse-string sutures is because it's done without any cutting. I've been under the knife several times already for my breasts and I really don't want to go through anymore. But from what I heard, the results with purse-string sutures on breasts don't always come out good. And additional procedures may be necessary to make things more symmetrical.
So I'm really confused. I don't know if I should go ahead with this or not. But I'm happy to hear that your sister had the procedure with successful results. Maybe I need to find a doctor who is more familiar with this reconstruction method and who has enough experience in it.
@ddljohn-- Oh wow! Really?! How is that procedure done? I have never heard about that before and would have never guessed that it's possible to place purse-string sutures in the eyes. That's very interesting.
The only procedures I know of where the purse-string surgical suture is used often are breast surgeries. My sister, who is a breast cancer survivor, had the procedure to create nipples from the excess skin there.
Many women who have breast cancer have to have their breast removed because of spreading cancer. Some women get implants to replace them but the implants are missing nipples and the natural look of breasts. But doctors can place purse-string sutures afterward to make nipples or fix the shape and size of the areola (dark area around the nipple).
My sister also has permanent sutures in place for this purpose. She even got the "nipples" and the new areola tattooed to make them look as close as possible to the natural form.
My father had purse string sutures placed in his eyes for vision problems. He had a previous eye surgery which really damaged his vision. He developed extreme farsightedness that he didn't have before. So his doctor placed permanent purse-string sutures to reduce his vision problems.
It has really helped and his vision is much better now. The doctor said that the farsightedness might return in the future. But thankfully, he can make adjustments to the sutures to fix any vision problems if they do come up.
We were very apprehensive about the whole procedure at first. It's not easy and definitely requires a lot of skill. But experienced eye doctors are able to do it successfully. If this didn't work, we had one or two other options to fix my dad's eyesight. But I'm glad this has worked out for him.
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