Usefulness of a Novel Pinwheel-shaped Incision Technique for Skin Tumor Excision

Use of the fusiform ellipse excision technique is the most common method for direct closure of circular and elliptical defects. To prevent dog-ear formation after suturing, the long-axis length of the fusiform ellipse should be ≥3 times the transverse dimension and the angle formed by the 2 lines at both ends should be <30°. We devised a pinwheel-shaped incision technique for skin tumor excision that could reduce the scar size. We aim to present this technique and report its results and usefulness. We included 50 patients (55 cases; 54% women; mean age, 39.8 years) who underwent surgery using our pinwheel-shaped incision technique between January 2016 and December 2018. The incision line was designed like a pinwheel around the tumor, and the excess skin was trimmed after suturing at the center. The length-to-width ratio was calculated using the width before the operation and the suture length at the end of the operation. The operation site was primarily the face, and the maximum tumor width was 48 mm. The postoperative suture line length was 2.1 ± 0.2 (mean ± SD) times the width of the excision area. There were no complications such as skin necrosis, and no patient required reoperation because of dog-ear formation. Our new pinwheel-shaped incision technique allows shortening of the length-to-width ratio compared with that required in the conventional method and helps avoid dog-ear formation. We successfully used this technique in 55 cases and confirmed its usefulness.