An elliptical skin excision can cause corners of redundant skin to rise at the apices known as ‘standing cones’ or ‘dog ears’. We describe a simple visual aid to illustrate this, which we find effective in our discussion of complications when taking pre-operative consent. Abduction of the thumb using the gap between the index finger and the thumb to represent the outline of the ellipse corner, followed by adduction as the excision margins close, raises the skin of the dorsum of the first web space like a dog ear, which is presented to the patient (Figs 1 and 2).
Figure 1.
Outline of hand simulating wound to be closed.
Figure 2.
The wound is closed and the ‘dog ear’ appears.