SUTUREGARD®
Clinical Cases
Large Scalp Defect After Skin Cancer Removal
![Defect following Mohs Surgery]()
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60 yo female with 4.2 x 7.6 cm scalp defect resulting from Mohs surgery of a basal cell carcinoma. Wound could not be initially approximated. Three SUTUREGARD® Devices used to expand tissue over 2 hours. Wound width decreased from 4.2 cm to 2.0cm. Force to close wound reduced from 25.0N to 8.5N. Allowed linear closure with three 3-0 PDS buried sutures and staples. Wound fully healed at two week staple removal.
Defect following Mohs Surgery
![Defect following Mohs Surgery]()
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3.3cm wide defect following Mohs surgery for a basal cell carcinoma. 0 nylon retention suture with SUTUREGARD ISR bridge and guide used to relax skin for 45 minutes with progressive tightening. This allowed for layered linear closure and excellent final cosmesis
Circular defect following remove of Basal Cell Carcinoma
![Circular defect following remove of Basal Cell Carcinoma]()
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3.5 cm wide circular defect following removal of basal cell carcinoma on cheek/sideburn. 0 nylon retention suture with SUTUREGARD ISR bridge and guide used to relax skin for 60 minutes with progressive tightening. This allowed us to perform a layered linear closure instead of large cheek flap.
Two defects following Mohs Surgery
![Two defects following Mohs Surgery]()
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Two defects following Mohs surgery to remove basal cell carcinomas on the upper temple and forehead. 0 nylon retention sutures with SUTUREGARD ISR bridges and guides used to relax skin surrounding each wound for 45 minutes with progressive tightening. This allowed us to perform layered linear closure on both lesions (allowing a small central portion in one of the wounds to heal by second intent).
Very large defect following Mohs Surgery
![Very large defect following Mohs Surgery]()
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Very large (12cm x 10cm) defect of the right parietal scalp following Mohs excision of an ulcerated basal cell carcinoma in a patient unable to tolerate general anesthesia. 0 nylon retention sutures with SUTUREGARD ISR bridges and guides used to relax the skin around the wound for 90 minutes with progressive tightening. This allowed us to partially close the wound and reduce the graft area to 7cm x 4cm (a 76% reduction in graft size). Skin was removed from the upper arm to graft the remaining defect. Her hair style allowed this grafted area to be completely hidden. Using the SUTUREGARD ISR skin relaxation method, we were able to avoid a flap or large graft in an office setting under local anesthesia.