Reciprocal incisions for closure of circular skin defects

With the use of a circular incision, adequate safe margins are obtained and, at the same time, waste of sound skin is minimized. The main problem is that the resultant circular defect may prove to be very difficult to close. Several methods currently used to close a circular defect are described. The use of the reciprocal incisions provides a method of closure that adapts to the size of the lesion and to the anatomical characteristics of the skin. A detailed description of this technique is given for each of the reciprocal incisions (double S, bow tie, and combined V-incision). A geometrical analysis in reference to the size of th incision, waste of sound skin, length, profile, and plasticity of the suture line is presented. A model to measure the skin after closure of a circular defect is described. The real advantage in choosing one of the reciprocal incisions lies on the resultant profile and plasticity of the suture line. Finally, the practical application of the reciprocal incisions is discussed.