When the lengths of two opposite sides of a wound are uneven, simple closure can distort the adjacent skin, resulting in formation of a “dog ear.”  Typically, this can be avoided by placing the suture in the midpoint of each side of the wound and bisecting the wound sequentially.  However, the dog ear can be an unavoidable consequence if there is gross disparity of wound edge lengths, especially with use of techniques like the “V-to-Y” conversion.

Several techniques are described for correcting a dog ear.  If the cause is simply a failure to place sutures equally on each wound edge, I would recommend removing the sutures and starting again. On the other hand, if the dog ear is unavoidable, as in cases where the edges of the wound are of different lengths, here is a simple technique to fix it.

Incise the skin at the apex of the wound, ~45 degrees relative to the line of the wound, in the direction of the dog ear.  This will free the excess tissue.  Align this with the newly created wound and you can determine the margins of excess tissue to be excised, typically a triangular shape.  The newly created wound edges lie flat and can be sutured closed in the usual fashion.

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