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

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Dog ear deformity is a frequent, aesthetically concerning complication of cutaneous surgery.
• It arises from excess tissue during wound closure, causing cosmetic issues and discomfort.
• Current management techniques lack clear evidence of superiority or situational applicability.

Purpose of the Study:

• To systematically review and assess best practices for managing dog ear deformities in cutaneous surgery.
• To identify and compare available techniques for dog ear correction.
• To propose an evidence-based algorithm for dog ear management.

Main Methods:

• A systematic literature search was conducted for relevant English-language articles involving human subjects.
• Inclusion criteria focused on studies addressing dog ear management in cutaneous surgery.
• Analysis included 36 articles, comprising case reports, technique descriptions, and observational studies.

Main Results:

• Twenty-three techniques or case reports and 6 observational studies were identified, with no randomized controlled trials.
• Ten major techniques for dog ear management were found in the literature.
• No single technique was definitively proven superior, and no consensus algorithm existed.

Conclusions:

• Preventative measures, including avoiding pre-planned elliptical designs and employing skin-conserving excision with meticulous closure, are crucial.
• While no single technique is universally recommended, surgeons should be familiar with various methods for optimal patient outcomes.
• An algorithm for dog ear management is proposed, pending further research.