Partial Purse String Suture with Delayed Reconstruction for a Large Defect Abutting a Free Margin.

Dear Editor: Reconstructing large defects near regions where mobility is functionally important, such as the eyelids, the lips and the joints, remains challenging for dermatological surgeons. Especially for defects near the eyelids or the canthus with a free margin, high tension should be avoided because of the lack of counter or opposing force. Using purse-string suture (PSS), a technique commonly used for reconstruction, for such sites may cause negative functional and cosmetic outcomes. Here we present a large surgical defect adjacent to lateral canthus that was successfully closed by modified PSS followed by secondary intention healing and rhombic flap. A 70-year-old man with a history of hypertension presented with irregularly shaped skin colored mass on his right periocular area. Histopathologic examination revealed typical feature of primary cutaneous mucinous carcinoma including