Pursestring Suture not healing

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Hope this is in the correct group? - My elderly mother of 90yrs old had a non malignant skin cancer removed from her scalp and a purse-string suture was used - this has still not healed after 9 months despite the doctors saying it would by applying a twice weekly plaster with yellow parraffin applied ?? We are due to go back next month for an appraisal - but is this normal procedures?

Thanks

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6 Replies

  • Posted

    Hello,

    This sounds a bit unconventional. Most surgeons would just do normal sutures or use a skin graft on the scalp if the defect is too large. I also haven't seen anybody using yellow paraffin on the wound. Although I am not saying this treatment is wrong, it is not widely used.

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    • Posted

      Thanks for answering - I also thought a skin graft would have been a better option- the wound is still so deep that you can see the skull? - Is there a better healing agent available or should we press for a skin graft?

      Thanks again

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  • Posted

    Hello again,

    Obviously I can't give you a proper consultation over the internet. However, this is what I generally do:

    For small skin cancers, I would close the wound directly, for larger wounds I use a skin graft from the head and neck area (full thickness grafts) and for even larger wounds I use a skin graft from the thigh (split skin grafts). Difficult wounds can either be left open or treated with a split skin graft.

    If the wound doesn't heal and looks healthy, I use a split skin graft.

    If the wound looks infected, I treat it with antiseptic dressings and then wait til it heals or use a split skin graft.

    If bone is exposed and looks healthy I use hydrocolloid dressings and wait until tissue grows over it (skin grafts often don't heal on exposed bone).

    If there is no tissue growth, then I would  move some scalp tissue into the defect - however this might not be suitable in an elderly patient with medical problems.

    From the information given it therefore seems that this would best be treated with moisturising dressings. Yellow paraffin might be ok for this - I personally use hydrocolloid dressings as mentioned above and have seen good results in my patients. However, I would advise to discuss this personally with a doctor since I can't consult over the net.

    I hope that helps.

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    • Posted

      Thanks very much Sir for your response again - I will continue to use Duoderm and yellow parrafin and see if it starts to close

      Thanks

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  • Posted

    Pleasure, get back to me if you have any more questions.
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    • Posted

      Thanks then I just thought I would dress the wound (this time) just with the hydrocolloid dressing (Duoderm) and leave out (this time) the yellow parraffin as the combination doesnt seem to have helped the healing at all and as these dressings help to retain moisture then using it alone might just help?
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