Background: As traditional elliptical excisions for skin tumors are designed before surgery, they may waste normal tissue and result in poor outcome, both in terms of the wound length and direction. Objective: To compare the predicted results of elliptical excisions with scars resulting from round excisions with dog ear repairs. Methods: Forty-one patients with skin tumors were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. Only the lesion and the required margin of adjacent skin were excised and closed with dog ear repairs. Precise measurements were conducted at each step. Results: Although many of the lesions required 2 dog ear repairs (59%), the overall sutured wound length was 14% shorter, and the wound direction differed from that of the predicted ellipse in 22% of cases. The shortening effect was distinctive in areas of thick skin, such as the trunk and scalp. Only 3 lesions resulted in a longer final wound length. In total, 29% of the patients required 1 dog ear repair and 12% needed no dog ear repairs. Conclusion: Round excisions with dog ear repairs should be considered prior to traditional elliptical excision as a more beneficial method of skin tumor removal.

1.
Bennett RG: Fundamentals of CutaneousSurgery. St Louis, CV Mosby, 1988, pp 370–372.
2.
De Hoff PHG, Key JE: Application of the finite element analysis to determine forces and stresses in wound closing. J Biomech 1981;14:549–554.
3.
Hudson-Peacock MJ, Lawrence CM: Excision with dog ear repair is superior to elliptical excision. Br J Dermatol 1993;129(suppl 42):48.
4.
Vaughan TK, Samlaska CP, Mulvaney MJ: Hello tricone; good bye ‘dog-ear’ (letter). Arch Dermatol 1990;126:1366.
5.
Dzubow LM: The dynamics of dog-ear formation and correction. J Dermatol Surg Oncol 1985;11:722–728.
6.
Lieneke JD, Fenike RT, Ynonne AB, et al: The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg 2004;113:1960–1965.
7.
Hudson-Peacock MJ, Lawrence CM: Relation between size of skin excision, wound, and specimen. J Am Acad Dermatol 1995;32:1010–1015.
8.
Weisberg NK, Nehal KS, Zide BM: Dog-ears: a review. Dermatol Surg 2000;26:363–370.
9.
Zitelli JA: Tips for a better ellipse. J Am Acad Dermatol 1990;22:101–103.
10.
Zitelli JA: Tips for wound closure: pearls for minimizing dog-ears and applications of periosteal sutures. Dermatol Clin 1989;7:123–128.
11.
Hudson-Peacock MJ, Lawrence CM: Comparison of wound closure by means of dog ear repair and elliptical excision. J Am Acad Dermatol 1995;32:627–630.
12.
Gormley DE: The dog-ear: causes, prevention, correction. J Dermatol Surg Oncol 1977;3:194–198.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.