Sutura Jareta o bolsa de tabaco: Se utiliza para invaginar muñones, cerrar cavidades o conductos o bien un saco herniario.

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Sutura en bolsa de tabaco

Sutura continua en la que la línea de sutura tiene una forma circular, de modo que al estirarla y anudar los dos extremos del hilo, el tejido suturado tiende a aproximarse al punto central del círculo, de modo que se cierra como una talega.


Medical Definition of purse–string suture

: a surgical suture passed as a running stitch in and out along the edge of a circular wound in such a way that when the ends of the suture are drawn tight the wound is closed like a purse

https://www.merriam-webster.com/medical/purse-string suture

Reconstruction of Areolar Projection Using a Purse-String Suture Technique

We describe a surgical technique using a purse-string suture for improved areolar projection. After creation of nipple–areolar complex using a CV flap, evenly spaced stab incisions are made in a circular pattern, approximately 5 mm outside of the boundary of the proposed areola. Using these incisions, a nonabsorbable purse-string suture is placed in the deep dermis. The diameter is cinched down to the desired measurement, providing areolar projection.

The attention is then shifted to the creation of areolar projection. Using the contralateral areola diameter as a template (in unilateral reconstructions) or forming symmetric patterns (in bilateral reconstructions), 12–15 small curvilinear (around 2 mm each) skin incisions are evenly (about 8 mm) spaced approximately 5 mm outside of the desired areola diameter with an 11 blade scalpel. A double-armed 2-0 Ethibond/GoreTex or Prolene suture is then placed in either direction, through the previously created skin incisions, starting at 12-o’clock position. This is kept relatively deep to prevent suture spitting or showing through the skin. The purse-string suture is completed on meeting of both ends at the 6-o’clock position (Fig. (Fig.1).1). The areola diameter is then cinched down to the desired measurement, thereby elevating the areola and decreasing tension on the base of the nipple creation by countering the radial pull of the surrounding tissue. The curvilinear incisions are closed with 6-0 chromic sutures (Fig. (Fig.2).2). The NAC is then tattooed about 2 months after the above-mentioned procedure to complete the breast reconstruction. Fine-tuning of the areola diameter can be performed at this time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527627/


Consent Patients should be warned that breast feeding will not be possible after ... now evert and maintain it in position by using a fine Vicryl purse-string suture. ... 0 Use a 3/0 Vicryl suture to close the breast tissue or subcutaneous fat in the ...

https://books.google.com.ar/books?id=7po3KL0J7BwC&pg=PA172&l... vicryl purse-string suture&f=false

.. owing to the risk of destroying healthy parenchyma or disfiguring the breast. ... Vicryl (polyglactin 910) purse-string suture is placed through the nipple base to ...

https://books.google.com.ar/books?id=7po3KL0J7BwC&pg=PA172&l... vicryl purse-string suture&f=false

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Note added at 1 hr (2017-08-01 23:55:01 GMT)
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NAC creation is a critical step in breast reconstruction. In a study published by Wellisch et al,1 the patients who had NAC creation as a part of their breast reconstruction reported significantly greater satisfaction compared with the patients who did not undergo NAC creation for their breast reconstruction. Distortion, flattening, and widening of the areola are commonly seen with periareolar surgery in mastopexy and reconstruction.14–16 Loss of natural areolar projection can result in a digression from the preoperative NAC appearance and may cause anxiety or distress to the patients.

CONCLUSIONS
This article describes a novel technique for creation of natural areolar projection in the reconstructed breast. Usage of purse-string suture technique with permanent suture may result in sustained areolar projection, while decreasing tension on the base of the newly created nipple. The improved aesthetic outcomes of NAC creation can result in improved patient satisfaction.