Comparison the Cosmetic Outcome of the Triangular Flap Insertion Versus Direct Linear Resection in Correction of Dog Ear Deformities on the Face—A Prospective and Randomized Controlled Trial

BACKGROUND: Compared with direct linear resection, the triangular flap insertion method is a correction method that purportedly reduces the incision tension of dog ears deformity. Randomized clinical trials comparing these 2 methods seem to be limited or absent. OBJECTIVE: A randomized study was planned to compare the cosmetic effect and scar in the defect area between the triangular flap insertion method and direct linear resection in the repair of dog ear deformities after the suture of the facial circular defect. METHODS: The authors' study was prospective, 2-arm, randomized, evaluator-blinded clinical trial in a single-center outpatient academic plastic surgery center. Patients were eligible if they or their parents were able to provide informed consent and had dog ear deformity higher than 8 mm at both ends of the incision after suture of a circular or oval facial defect. Each dog ear deformity at the ends of the incision, half accept direct linear random resection, the other half to accept triangular flap insert. At 3-month and 6-month follow-up, each patient and 2 blinded observers evaluated the wound using the Patient Observer Scar Assessment Scale (POSAS). RESULTS: In all, 52 subjects completed the study. At the 3-month follow-up, there was a statistically significant difference in the mean total POSAS scores for both the blinded observer and patients, indicating a preference for the side with the triangular flap insertion method. However, at the 6-month follow-up, this difference was lost. CONCLUSION: Three months after surgery, the triangular flap insertion method resulted in a better scar outcome than direct linear resection in correction of dog ear deformities on the face. At 6 months' follow-up, this difference diminished, with scars for both sides appearing similar. LEVEL OF EVIDENCE: Level II.