Tissue conservation using circular defect with dog-ear deformities excision technique

Compare circular defect with dog-ear deformities excision (CDDE) technique to 3:1 fusiform excision technique when removing facial lesions to analyze which technique provides superior wound closure.

Identical 1-cm circular skin defects were created on bilateral cheek, forehead, and parietal scalp on three fresh cadavers. Similarly, using four fresh cadavers, identical 2-cm circular skin defects were created on bilateral cheek, forehead, and scalp. In both the 1-cm and 2-cm circular defects (n = 19), a 3:1 fusiform excision and closure was performed on one side of the cadaver head for control. On the opposite side, CDDE excision technique was performed. The following measurements were recorded: circumferential incision length after tissue excision, average of wound widening widths after an approximation suture was placed at the halfway point, and the final incision length after primary closure. Final incision length upon closure was divided by the original defect size to obtain a final incision length to defect ratio. A paired t-test was performed on all variables for analysis.

When using the CDDE excision technique, there were statistically significant decreases in circumference, average wound widening, final incision length in both 1-cm and 2-cm circular defects (P < .01). The final incision length upon closure to defect ratio in CDDE excision was approximately 2.5:1, whereas 3:1 fusiform excision resulted in the final incision length to defect ratio of approximately 3.5:1.

When compared to fusiform excision technique, CDDE excision technique appears to minimize tissue excision, decrease wound widening and the final incision length.