title: Guitar-String Suture to Facilitate Closure of a Finger-like Flap for Reconstruction of the Nose.
abstract: BACKGROUND
  The basic principle of a lobed or finger-like transposition flap is that, after covering the defect with the transposed tissue, the donor site is closed primarily. With large defects, a second lobe may be added to the flap if primary closure of the area left by the first lobe is not possible. The flap can often be made to adapt to the defect, but this maneuver, in combination with primary closure of the adjacent tissue, can sometimes produce excessive tension and compromise the blood supply.
  
  
  METHODS
  We present a series of 4 patients with epithelial tumors of the lateral wall of the nose. The defects left by surgical excision were covered by finger-like transposition flaps. Subcutaneous sutures called guitar-string sutures were used to reduce the size of the defect and facilitate tension-free closure.
  
  
  CONCLUSIONS
  We propose use of the guitar-string subcutaneous suture in those cases in which the defect is larger than the area that can be covered by the flap. This will make it easier to adapt the flap to the defect and will reduce the risk of excessive tension causing necrosis of the transposed tissue.
authors.affiliation: Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: E
authors.initials: E
authors.lastname: Querol-Cisneros
authors.affiliation: Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España. Electronic address: predondo@unav.es.
authors.forename: P
authors.initials: P
authors.lastname: Redondo
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques
keywords: Colgajo de trasposición; Guitar-string suture; Nasal reconstruction; Reconstrucción nasal; Suturas en cuerda de guitarra; Transposition flap