The Difference of Interleukin-6 Level and Seroma Volume Between Quilting and Conventional Suture After Modified Madical Mastectomy

Abstract

Background: Modified radical mastectomy is the standard surgical therapy for locally advanced breast cancer (LABC). Seroma as the most common complication after MRM has many morbidities. Quilting suture after MRM to prevent dead space consistently decreased seroma formation on many studies. However, it is not widely applied in Indonesia. Interleukin-6 (IL-6) on the other hand has also been known to affect seroma production. However, the correlation between these two has not been well studied. Objective: To know the difference of IL-6 level and seroma volume between quilting and conventional suture after MRM in LABC. Methods: This study is a randomized controlled trial conducted from April to July 2022 with permuted block randomization which allocated samples that suited the inclusion and exclusion criteria into intervention group (quilting suture) and control group (conventional suture). Results: The average difference of total seroma volume between the two groups were 399.25 mL (p=0.000). The average difference of Interleukin-6 level between the two groups was 3160.75 mL (p=0.000). The result of linear regression shows that the total time needed for wound closure (p=0.029; 95%CI: 183.291 – 592.605) and the quilting technique (p=0.018; 95%CI: 1727.971- -8101.730) were two variables that affected the level of IL-6 in the seroma and were statistically significant. Adjusted R2 value was 0.118 indicating the effect of the two variables on the change of seroma volume was 11.8%. Conclusion: Quilting suture significantly reduced the total volume of seroma as well as the IL-6 level in the seroma after MRM in LABC. IL-6 level was also significantly affected by the duration needed for wound closure.