“Dog ears”—an inappropriate terminology used to describe wound edges

“Dog ears”—an inappropriate terminology used to describe wound edges Eur J Plast Surg (2010) 33:381 DOI 10.1007/s00238-010-0449-x LETTER TO THE EDITOR “Dog ears”—an inappropriate terminology used to describe wound edges Syed A. Mashhadi & Charles Yuen Yung Loh Received: 21 April 2010 /Accepted: 3 May 2010 /Published online: 25 May 2010 Springer-Verlag 2010 Sir, been used to describe similar pathology as a substitute but Dog ear or pig ear is an expression used by surgeons to have not become popular. describe a portion of excess tissue and skin that protrudes at In some cultures, referring a body part to a dog or a pig both ends following the closure of unequal margins of the cannot only be insulting but is religiously unacceptable. We wound under uneven tension. believe that the impact of such a term is more far reaching One might get the impression that this term is not only than we think as dog ears do occur and sometimes are left lacking in scientific accuracy but also carries a derogatory on patients to settle by themselves. One has to be very implication of resembling a part of an animal body used for careful to select the terminology in explaining this a human being. Dog ears are usually the result of poor occurrence to a patient. It would be far better to use the planning and execution of surgical incisions, a price one term “spike” or “topped peak” at the wound ends to has to pay at the time of wound closure. However, describe it. These terms are simple, patient friendly and sometimes dog ears are inevitable as these could be related self-explanatory yet not degrading. to the biological nature of the skin or shape of the lesion to Hence, we propose that the term dog ear should be be excised. This can happen to all the wounds regardless of abandoned in medical literature and should be replaced their aetiology, their size or position on the body. Dog ears with words like “spike” or “topped peak” as in today's are commonly seen with dermolipectomies [1]. litigious climate, being able to communicate more tactfully It is not clear when and how this term was introduced as a surgeon is almost as important as being able to perform into the medical literature, but the first ever mention of this an operation. complication of wound closure was by Limberg in 1966 [2]. He used the words “standing cone or lying cone” to describe the dog ear. According to our careful literature References search, Borges was the first one to describe the term dog ear or pig ear for wound closure in his article in 1982. Since 1. Borges AF (1982) Dog-ear repair. Plast Reconstr Surg 69 then, other names such as pucker [3] or tricone [4] have (4):707–713 2. Limberg AA (1966) Design of local flaps. In: Gibson T (ed) Modern trends in plastic surgery, 2nd edn. Butterworth, London, p 39 S. A. Mashhadi (*) C. Y. Y. Loh 3. Bennett RG (1988) Fundamentals of cutaneous surgery. Mosby, St Great Ormond Street Hospital, Louis, pp 473–483 London, UK 4. Vaughan TK, Samlaska CP, Mulvaney MJ (1990) Hello tricone; e-mail: smashhadi@hotmail.com goodbye ‘dog ear’. Arch Dermatol 126:1366 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

“Dog ears”—an inappropriate terminology used to describe wound edges

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Copyright © 2010 by Springer-Verlag
Medicine & Public Health; Plastic Surgery
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