Unless you are using the integrated recovery solution and snapshotting your machines before patch deployment, you have to run an uninstall somehow. We use Software Delivery to deploy the uninstall options for any patches that we need to roll back. Example shown below of a program to uninstall the MS006-042 (KB918899) patch. Package contains no source files and I have a program that has the following command line to uninstall the patch if needed.
%windir%\$NtUninstallKB918899$\spuninst\spuninst.exe /quiet /norestart
Nate Hudson
Senior Systems Engineer
West Bend Mutual Insurance