"PURSE STRING" YÖNTEMİNİN ŞAKAK BÖLGESİNDEKİ GENİŞ DEFEKTLERE UYGULANMASI

Yıl 2007, Cilt: 15 Sayı: 3, 144 - 149, 01.12.2007

Şükrü Yazar Berna Kılıç Ali Gökkaya

Öz

Baş boyun bölgesi deri tümörlerinin çıkarılması sonucu genellikle oval ve dairesel defektler oluşur. Bu defektlerin onarımı için beş seçenek vardır; sekonder yara iyileşmesi, primer kapama, deri greftleri, deri flepleri ve serbest doku transferleri. Yüz bölgesindeki geniş cerrahi defektlerin onarımı sıklıkla zor olabilir. "Purse string" sütur bu tarz yüzeysel geniş defektlerin deri flebi veya grefti ihtiyacını azaltmak için kullanılabilir. Özellikle derinin elastik olduğu alanlardaki defektler için uygundur. Şubat 2005- Ağustos 2006 tarihleri arasında, tümör eksizyonu sonrası gelişen 7 şakak bölgesi defekti "purse-string" sütur tekniği uygulanarak küçültüldü ve kalan alanlar tam kat deri grefti ile onarıldı. Bütün defektler belirgin olarak küçüldü ve küçük boyutlarda deri greftine gerek duyuldu. Başlangıçta deri büzüşmesi ve belirgin çekilme gözlendi ama bunlar zamanla düzeldi. Önemli komplikasyon gözlenmedi. Kozmetik sonuçları iyi olarak değerlendirildi. Bu teknik uygun vakalarda cerrahi defektleri kısmen kapatabilmek için basit, ucuz ve kozmetik sonuçları kabul edilebilir bir yöntemdir

Anahtar Kelimeler

“purse-string” sütur, Şakak bölgesi onarımı, Deri kanser cerrahisi

PURSE STRING SUTURE METHOD FOR LARGE DEFECTS ON TEMPLE AREA

Öz

Excision of skin cancers in the head and neck region usually results in a circular or oval defect. There are five options for treating the wound; healing by secondary intention, primary closure, skin grafting, local skin flap, and microsurgical free tissue transfers. Large surgical defects on the face can often be difficult to repair. The purse-string suture may be used in such superficial large defects, reducing the amount of skin flap or graft required. It is particularly suited to defects where the skin is lax. Between February 2005 – August 2006, seven skin defects occurred after tumor excision on temple area were reduced with tightening purse string suture, and the remaining areas were covered with full-thickness skin grafts. All defects were considerably reduced in size and required a small skin graft to complete the reconstruction. Initially many redundant skin folds and considerable local distortion were seen, however these improved with time. No significant complications were observed. The final cosmetic outcome of this closure was found satisfactory. The technique is simple, inexpensive, and the cosmetic results are acceptable for partial closure of surgical defects in appropriately selected cases.

Anahtar Kelimeler

purse-string suture, Temple area reconstruction, Skin cancer surgery

Kaynakça

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