Mastectomy Scar Healing: A Comparative Analysis of Fibrin Sealant and Quilting Techniques Using the Hollander Wound Evaluation Scale

Introduction: Surgical scars represent both a cosmetic concern and an unavoidable surgical outcome. For patients, particularly those who have undergone a mastectomy, the scar serves as the primary external reminder of a significant medical experience. Understanding and evaluating patient perspectives on scarring is crucial for improving the correlation between clinical assessment and patient satisfaction scales. Post-mastectomy wound healing remains a significant concern in breast cancer management. This study evaluates the efficacy of fibrin sealant versus quilting techniques in mastectomy scar healing using the Hollander Wound Evaluation Scale (HWES). Materials and Methods: This prospective randomised study on breast cancer patients in Sokoto, Nigeria, compared two surgical techniques for modified radical mastectomy. Using a computer-generated randomisation with Microsoft excel, patients were divided/randomised into two groups: Group A used Fibrin glue to secure mastectomy flaps, while Group B used suture quilting. Both groups underwent skin closure with Nylon 2/0 sutures. Using a double blinding, the study’s primary outcome was scar cosmesis/healing, evaluated using the HWES, with secondary outcomes including hospital stay duration and wound infection rates. Results: The study recruited 84 patients with mean ages of 44.86 ± 7.88 and 45.00 ± 8.52 in Groups A and B, respectively. Optimal healing was observed in 29 (66.7%) patients in Group A and 36 (85.7%) in Group B. Hospital stay was significantly shorter in Group A ( P = 0.00). Post-mastectomy wound infection rates showed no statistically significant difference between groups ( P = 1.00). Conclusion: The fibrin glue and quilting suture technique demonstrated comparable optimal wound healing outcomes in mastectomy scar healing with HWES scores. However, the fibrin glue group had a shorter hospital stay with no difference in infection rate between the two groups.