Revisiting Y-Shaped Closure Technique to Prevent the Dog Ear Formation in Women Undergoing Mastectomy

Goel, Vipin; Shukla, Srijan; Raju, Kalyani; Murtuza, Syed; Ramchandra,; Rao, T. Subramanyeshwar

doi:10.1007/s13193-018-0848-1

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…16). [29][30][31][32][33][34] These preventative methods allow for the correction of asymmetry and for excess skin removal, as well as easy access to the axilla.…”

Section: Excision Of Redundant Tissuementioning

confidence: 99%

Dog Ears in Wound Closure

et al. 2022

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Conical deformities found at the apices of incisions after wound closure represent tissue redundancy, commonly known as “dog ears.” The amount of tissue excess is related to the geometry of the incision, surrounding skin elasticity, and tension of closure. Experience with tissue handling shows that some dog ears do “settle” or resolve with time; such cases occur when local tissue has high skin elasticity, the dog ears are small in height, and tension on the line of closure is low. Dog ears that do not fall into this category can be troublesome to surgeon and patient alike as they can poorly impact aesthetic outcomes and lead to secondary revision procedures. Therefore, we present a pertinent review of the mechanisms behind dog-ear formation and the variety of surgical techniques used to minimize and correct their formation.

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“…16). [29][30][31][32][33][34] These preventative methods allow for the correction of asymmetry and for excess skin removal, as well as easy access to the axilla.…”

Section: Excision Of Redundant Tissuementioning

confidence: 99%

Dog Ears in Wound Closure

et al. 2022

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“…When closing the wound horizontally after mastectomy, the skin tension is usually severe in the middle of the chest wall, while the skin of the lateral chest wall tends to be redundant, which makes a dog-ear deformity and can make a patient uncomfortable when mobilizing the arm. Several techniques have been reported to prevent the lateral dogear deformity including fish-shaped incision, a triangular advancement technique and L scar technique [9,10]. Triangle technique is a novel procedure to prevent the dogear deformity in which the skin and subcutaneous fat of the axilla are cut into an equilateral triangle [11].…”

Section: Introductionmentioning

confidence: 99%

Skin grafting utilizing a skin of lateral thoracic area for chest wall reconstruction in patient who underwent mastectomy for locally advanced breast cancer

et al. 2020

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Locally advanced breast cancer sometimes results in a large chest wall defect at mastectomy. When closing the wound horizontally, the skin tension is usually severe in the middle of the wound, while the skin of the lateral area tends to make a dog-ear deformity. Triangle technique is a procedure to prevent the dog ear in which the skin and subcutaneous fat of the axilla are cut into an equilateral triangle. Herein, we present a case of breast cancer who underwent a mastectomy and closed the wound with a skin graft by utilizing the skin removed from lateral thoracic area using triangle technique. An 85-year-old female visited our institution complaining about the mass on her right breast. Preoperative images showed a 10 cm-sized mass with suspicious axillary and mediastinal lymph nodes swelling. A biopsy revealed a hormone receptor-negative, HER2positive invasive ductal carcinoma. A mastectomy and axillary lymph node sampling were performed for a local control as the tumor did not respond to four cycles of triweekly trastuzumab combined with S-1. After a transverse elliptical incision, a skin of the lateral thoracic area was harvested using triangle technique. As the middle of the wound had excessive closing tension, the skin was grafted on the defect. After 10 day fixation by a tie-over dressing, the wound healed without complications. This procedure is a simple method for closing a large defect after mastectomy preventing both the dog-ear deformity and a new wound scarring of a donor site.

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“…С увеличением массы тела наблюдается увеличение количества нелюминальных типов РМЖ. Статистические данные говорят о том, что у больных РМЖ без ожирения общая выживаемость и общая безрецидивная выживаемость значительно выше, также отмечена зависимость между поражением лимфатических узлов и ожирением [9,10]. Чан (2014) в своем исследовании отметил, что при ИМТ ≥30 кг/м 2 результаты лечения хуже, чем при ИМТ ≤30 кг/м 2 , с повышением ИМТ на 5 кг/м 2 риск летального исхода повышается на 18%, а от рака молочной железына 14%.…”

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“…Обычно лимфорея продолжается до 8-14, а у пациенток с ожирением с гипертрофированными молочными железамиболее 30-60 дней. В отдаленном послеоперационном периоде обильная лимфорея может приводить к грубому и хаотичному разрастанию рубцовой ткани в областях лимфаденэктомии и на участках отсепарования кожных лоскутов, что приводит к развитию «постмастэктомического синдрома»[10].Боковые «собачьи уши» (рис. 1) -остаточный кожно-жировой гребень в подмышечной ямке после РМЭ[11].…”

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