title: Delayed staged closure with repeated directional suturing of cutaneous defects.
abstract: BACKGROUND
  Postsurgical wound management is traditionally a choice between intraoperative surgical repair or healing by secondary intention. We describe a technique that combines intraoperative and postoperative surgical repair with granulation.
  
  
  OBJECTIVE
  Delayed closure with repeated directional suturing was evaluated as an alternative closure technique for large wounds.
  
  
  METHODS
  Sixty patients had surgical defects partially closed intraoperatively with postoperative staged closures over 2 to 4 weeks. Only those wounds that could not be closed intraoperatively without vascular compromise or anatomic disfigurement were treated.
  
  
  RESULTS
  All wounds were closed using skin from the same anatomic unit. Complications were minimal, and the results were acceptable to both the patients and the surgeon.
  
  
  CONCLUSIONS
  Delayed closure with repeated directional suturing is a reasonable alternative when primary closure is not possible or when it would cause anatomic disfigurement.
authors.affiliation: Department of Dermatology, University of Texas-Houston Medical School, and Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Tucker
authors.forename: Brian L
authors.initials: BL
authors.lastname: Ransdell
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D009668:Nose Diseases / Q000601:surgery*; D009824:Ointments; D011184:Postoperative Period; D012871:Skin Diseases / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D009824:Ointments