title: Secondary Intention Healing and Purse-String Closures.
abstract: BACKGROUND
  Secondary intention healing and purse-string closures are simple but extremely useful methods for the dermatologic surgeon to master.
  
  
  OBJECTIVE
  To review the literature on the use of these two types of closures and offer recommendations based on our collective experiences.
  
  
  METHODS
  A literature review was performed using the terms "secondary intention healing" and "purse-string closure." The evidence and recommendations from the resultant references were summarized in our article and synthesized with our own experiences.
  
  
  RESULTS
  Twenty-eight sources were cited overall with fifteen related to secondary intention healing, eleven pertaining to purse-string closures, and one randomized, blind clinical trial comparing the two modalities.
  
  
  CONCLUSIONS
  The art of dermatologic surgery often requires a tailored approach to the patient and can involve a spectrum of closures, from the simplest to most complex. This variety not only provides more reconstruction options, but are also necessary to keep dermatologic surgery cost-effective. Certain locations or situations are more amenable for these two types of closures than others. The use of secondary intention healing, either alone or in conjunction with purse-string closures, should be in every dermatologic surgeon's armamentarium.
authors.affiliation: *Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, Maryland; †Center for Dermasurgery, Cooper University Hospital, Marlton, New Jersey.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Lam
authors.forename: Christopher
authors.initials: C
authors.lastname: Lowe
authors.forename: Ryan
authors.initials: R
authors.lastname: Johnson
authors.forename: Jason D
authors.initials: JD
authors.lastname: Marquart
mesh_terms: D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D015580:Mohs Surgery / Q000379:methods*; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012871:Skin Diseases / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing