title: Round excisions lead to shorter scars and better scar positioning than traditional elliptical excisions.
abstract: BACKGROUND
  As traditional elliptical excisions for skin tumors are designed before surgery, they may waste normal tissue and result in poor outcome, both in terms of the wound length and direction.
  
  
  OBJECTIVE
  To compare the predicted results of elliptical excisions with scars resulting from round excisions with dog ear repairs.
  
  
  METHODS
  Forty-one patients with skin tumors were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. Only the lesion and the required margin of adjacent skin were excised and closed with dog ear repairs. Precise measurements were conducted at each step.
  
  
  RESULTS
  Although many of the lesions required 2 dog ear repairs (59%), the overall sutured wound length was 14% shorter, and the wound direction differed from that of the predicted ellipse in 22% of cases. The shortening effect was distinctive in areas of thick skin, such as the trunk and scalp. Only 3 lesions resulted in a longer final wound length. In total, 29% of the patients required 1 dog ear repair and 12% needed no dog ear repairs.
  
  
  CONCLUSIONS
  Round excisions with dog ear repairs should be considered prior to traditional elliptical excision as a more beneficial method of skin tumor removal.
authors.affiliation: Department of Dermatology, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.
authors.forename: Soo-Hong
authors.initials: SH
authors.lastname: Seo
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Son
authors.forename: Il-Hwan
authors.initials: IH
authors.lastname: Kim
mesh_terms: D002921:Cicatrix; D062109:Dermatologic Surgical Procedures; D006801:Humans; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods*