Fusiform Incision

Excerpt

The fusiform incision is a fundamental technique in surgical practice, particularly in the excision of cutaneous and subcutaneous lesions. This incision is frequently employed in dermatologic surgery, plastic and reconstructive procedures, and oncologic excisions due to its ability to convert round, oval, or irregular defects into linear closures, resulting in favorable cosmetic and functional outcomes. By removing tissue in a spindle-shaped or elliptical configuration with tapered ends, the fusiform incision facilitates direct primary closure while minimizing the risk of puckering, standing cones, or "dog ears" at the wound margins.

This geometric approach is critical for complete lesion excision and promoting healing along lines of minimal tension. Proper planning of the incision concerning relaxed skin tension lines, as well as accurate execution of width-to-length ratios and apex angulation, is essential to achieving optimal wound eversion, tension distribution, and scar aesthetics. This review discusses the principles of fusiform incision design, including key anatomic and biomechanical considerations, common pitfalls, and strategies for preventing contour deformities. Emphasis is placed on integrating sound surgical technique with aesthetic planning to ensure oncologic efficacy and patient satisfaction.