Evaluation of the effect of the accordion suturing technique on wound lengths in breast cancer surgery: a randomised clinical trial.

Abstract

Cosmetic outcomes and scar lengths remain important considerations in breast cancer surgery. Suturing techniques should decrease scar tissue formation and provide good cosmetic results. The use of an accordion suturing technique may result in decreased surgical wound lengths and better cosmetic outcomes. We compared the outcomes of the accordion suturing technique with the standard suturing technique in breast cancer surgeries. Female patients undergoing wide local excision of breast cancers were randomised to undergo closure of their surgical wound by either the accordion or the non-accordion (standard) suturing techniques between the months of May and October 2015. Pre-closure and post-closure wound lengths were measured intra-operatively. The primary outcome was a reduction of the surgical wound length at 6weeks. The secondary outcome was a composite of the absence of hypertrophic scar tissue formation and optimal cosmesis. Thirty eligible women for wide local excision of breast tumours were randomly assigned to the accordion and non-accordion groups (15 accordion and 15 non-accordion). Seven women were excluded from the study because they underwent re-excision of margins for their breast tumours before the end of 6weeks, and one woman was lost to follow-up. We therefore compared the outcomes of 12 women who underwent closure of their surgical wound by way of the accordion suturing technique to the outcomes of 10 women who underwent closure with the non-accordion (standard) suturing technique. The percentage reduction of wound length at 6weeks was significantly greater in the accordion group than in the non-accordion group (M = 24.4, SD = 10.2 vs. M = 8.6, SD = 11.5, p = 0.0026). There was no significant difference in the cosmetic outcome between both groups using the James Quinn's wound evaluation score. The accordion suturing technique was associated with a significant reduction in surgical wound lengths in breast conserving surgery at 6weeks without compromising the cosmetic result.