Cargando…

A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm

BACKGROUND: Dog ear, a characteristic bunching up of excess tissue formed during wound closure, is a common unsightly problem in cutaneous surgery. It may present as a cosmetic concern or a source of physical discomfort. Several management techniques have been reported, but it is unclear which appro...

Descripción completa

Detalles Bibliográficos
Autores principales: Kang, Ajaipal S., Kang, Kevin S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544318/
https://www.ncbi.nlm.nih.gov/pubmed/33133953
http://dx.doi.org/10.1097/GOX.0000000000003102
_version_ 1783591837008658432
author Kang, Ajaipal S.
Kang, Kevin S.
author_facet Kang, Ajaipal S.
Kang, Kevin S.
author_sort Kang, Ajaipal S.
collection PubMed
description BACKGROUND: Dog ear, a characteristic bunching up of excess tissue formed during wound closure, is a common unsightly problem in cutaneous surgery. It may present as a cosmetic concern or a source of physical discomfort. Several management techniques have been reported, but it is unclear which approach is the most effective or whether outcomes vary with surgical situations. This report assesses the best practices for dog ear management. METHODS: A systematic literature search was performed. All relevant articles written in English and involving human subjects were included. RESULTS: There were 2028 potentially relevant articles, but only 36 articles met the inclusion criteria. These articles were published in multispecialty journals. They included 23 techniques or case report articles, 6 retrospective and prospective studies, but no clinical trial or randomized control trial. Ten major techniques were identified in the literature. No single technique was proved to be superior in the literature. There was no recommended algorithm in the literature. CONCLUSIONS: Despite there being no single recommended technique to manage dog ear deformities, there is ample evidence to suggest surgeons avoid a pre-planned elliptical design, use a proper skin-conserving design for excision, and carry out a meticulous suture closure as the first steps to prevent dog ears. We discuss the indications for each of the ten techniques and propose an algorithm for dog ear management. Until further research is performed, multispecialty cutaneous surgeons should familiarize themselves with the discussed techniques to provide patients with the best functional and aesthetic results.
format Online
Article
Text
id pubmed-7544318
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-75443182020-10-29 A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm Kang, Ajaipal S. Kang, Kevin S. Plast Reconstr Surg Glob Open Reconstructive BACKGROUND: Dog ear, a characteristic bunching up of excess tissue formed during wound closure, is a common unsightly problem in cutaneous surgery. It may present as a cosmetic concern or a source of physical discomfort. Several management techniques have been reported, but it is unclear which approach is the most effective or whether outcomes vary with surgical situations. This report assesses the best practices for dog ear management. METHODS: A systematic literature search was performed. All relevant articles written in English and involving human subjects were included. RESULTS: There were 2028 potentially relevant articles, but only 36 articles met the inclusion criteria. These articles were published in multispecialty journals. They included 23 techniques or case report articles, 6 retrospective and prospective studies, but no clinical trial or randomized control trial. Ten major techniques were identified in the literature. No single technique was proved to be superior in the literature. There was no recommended algorithm in the literature. CONCLUSIONS: Despite there being no single recommended technique to manage dog ear deformities, there is ample evidence to suggest surgeons avoid a pre-planned elliptical design, use a proper skin-conserving design for excision, and carry out a meticulous suture closure as the first steps to prevent dog ears. We discuss the indications for each of the ten techniques and propose an algorithm for dog ear management. Until further research is performed, multispecialty cutaneous surgeons should familiarize themselves with the discussed techniques to provide patients with the best functional and aesthetic results. Lippincott Williams & Wilkins 2020-09-23 /pmc/articles/PMC7544318/ /pubmed/33133953 http://dx.doi.org/10.1097/GOX.0000000000003102 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Reconstructive
Kang, Ajaipal S.
Kang, Kevin S.
A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title_full A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title_fullStr A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title_full_unstemmed A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title_short A Systematic Review of Cutaneous Dog Ear Deformity: A Management Algorithm
title_sort systematic review of cutaneous dog ear deformity: a management algorithm
topic Reconstructive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544318/
https://www.ncbi.nlm.nih.gov/pubmed/33133953
http://dx.doi.org/10.1097/GOX.0000000000003102
work_keys_str_mv AT kangajaipals asystematicreviewofcutaneousdogeardeformityamanagementalgorithm
AT kangkevins asystematicreviewofcutaneousdogeardeformityamanagementalgorithm
AT kangajaipals systematicreviewofcutaneousdogeardeformityamanagementalgorithm
AT kangkevins systematicreviewofcutaneousdogeardeformityamanagementalgorithm