Abstract. The method of suturing for incisions is crucial for the comprehensive treatment of clinical patients with breast cancer. Suturing is considered a major part of post-surgical recovery and may serve as a marker for evaluation of surgical outcome. The present study aimed to establish an effective means of suturing for patients who received modified radical surgery that helps to improve the cosmetic outcome of the incision. Enrolled patients were divided into an active and a control group. Ti-Ni memory alloy wire for intradermal suture in the active group and silk for interruption suture in the control group were applied to assess the different prognosis-associated factors. The Vancouver Scar Scale (VSS) was used to evaluate the wound size and the recovery time of the scars. The association between diabetes and the number of days of wound healing was also analyzed. The results indicated that the mean VSS score of the active group was decreased compared with that of the control group (P<0.001). The VSS scores of four main features (vascularity, pigmentation, pliability and height) between the two groups also statistically differed (P<0.001). Furthermore, the mean number of days of wound healing was significantly decreased for the active group compared with that for the control group (P=0.0026) in the patients with diabetes. In addition, the usage of Ti-Ni memory alloy wire was able to decrease the mean number of wound healing days between patients with diabetes and their non-diabetic counterparts (P=0.7009). The present study indicated that intradermal suture offers improved cosmetic outcome for patients undergoing mastectomy with or without axillary surgery. This technique may be useful for preventing scar overgrowth and for facilitating the recovery process in patients with diabetes.
IntroductionIn 1882, Halsted pioneered the radical resection of the breast. Breast surgery methods have changed since and clinicians commonly perform breast-conserving surgery. However, the optimal approach for radical resection remains controversial (1). Along with social progress and improvements in the quality of life, patients with cancer, particularly patients with breast cancer have increasing requirements for the function and cosmetic outcome following surgery (2,3). A previous study identified that 61% of patients reported that the opinions of their partners of the scars were important to them (4). The way an incision is closed and managed post-operatively affects cosmetic outcome (5). Historically, in breast cancer surgery, simultaneously ensuring treatment effect, shrinking excision scope and attending to the cosmetic effect has been important (6). To improve the aesthetic results for female patients undergoing breast cancer surgery, surgical techniques have been developed to render scars less noticeable (7,8).In China, the majority of patients with breast cancer are treated with modified radical surgery using discontinuous silk suture, which leaves a very noticeable scar (9). A study on cosmetic surgery identified ...