Figure 1 A 2-cm mass showing 2-cm margins as drawn

An elliptical incision drawn around the margins to result in aesthetic closure. The owner should always be warned about the length (and appearance) of the incision in relation to the size of the mass. The rules of an elliptical incision are also applicable to circular wounds.

Figure 2 Excised mass and margins

Once the mass and margins have been excised, the skin is retracted further, giving the appearance of a much larger defect.  

Figure 3 Tacking sutures

Wound closed by placing tacking sutures perpendicular to the lines of tension (white lines). Note the appearance of dog ears (red arrows), along with a large amount of tension and gapping at the middle of the incision.

Figure 4 (A and B). Prominent dog ears

After the wound has been closed perpendicular to the lines of tension, prominent dog ears will be evident, as depicted from a horizontal perspective (A); a close-up view (B) more distinctly shows one of the dog ears.

Figure 5 (A and B). Subcuticular sutures in place (perpendicular closure)

Even with placement of subcuticular sutures (A), considerable tension in the center of the incision can still remain (B), along with dog ears. Figure B demonstrates the lines of tension present with this incision.

Figure 6 Parallel closure

When closing the incision parallel to the lines of tension, tacking sutures are not always necessary. Note the lack of gapping along the incision. Sometimes tacking sutures are placed to relieve dead space, rather than being placed to alleviate tension.

Figure 7 Subcuticular closure (parallel)

Note that after subcuticular closure, there is no tension in the middle of the incision nor dog ears present at the ends. Instead, skin apposition is excellent and the skin is smooth.

Figure 8A Basic representation of tension lines

Basic representation showing tension lines (A and B) along the lateral aspect of a dog. It is important to remember that every dog has variations in skin pliability, thickness, and underlying fascial attachments. Assessment and placement of the lines of tension need to reflect the best closure result. 

FIGURE 8B Basic representation of tension lines

Basic representation showing tension lines (A and B) along the lateral aspect of a dog. It is important to remember that every dog has variations in skin pliability, thickness, and underlying fascial attachments. Assessment and placement of the lines of tension need to reflect the best closure result.