Beveled vs. Perpendicular Incisions and The Effects on Wound Healing: A Review

Proper surgical technique is crucial for optimizing wound healing and reducing scar tissue formation. There are numerous measures a surgeon can take to improve wound healing; however, the angle of the incision made at the surgical site has been suggested to potentially play a role in wound healing, particularly between beveled and perpendicular incisions.

The goal of this study was to analyze the literature and observe whether a discrepancy exists between using beveled vs perpendicular incisions in surgical procedures, as well as to understand the relationship between incision angles and physiologic wound healing.

Google Scholar, Pubmed, and MEDLINE searches regarding incision techniques were made to find relevant articles in the fields of plastic surgery, dermatologic surgery, periodontal surgery, and ophthalmic surgery which included studies from 2004 to 2023. The exclusion criteria consisted of studies that did not have a comparative design and/or were not revolved around incision angle.

After filtering out irrelevant studies, we selected six studies that addressed the dichotomy between beveled and perpendicular incisions. Out of the six studies, four were in favor of beveled incisions, and the remaining studies either found no significant difference or reported benefits to some degree of using perpendicular cuts.

The literature seems to suggest that beveled incisions have an advantage over perpendicular incisions in wound healing, particularly in the aspects of esthetic and accelerated wound healing. This is potentially due to the increased surface area of the dermis, preservation of hair follicles, and decreased incidence of infection.

Although the literature seems to favor beveled incisions, a definitive conclusion cannot be made as there is not sufficient evidence to support the superiority of one incision type over the other.