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Plastic Surgery/Breast Surgery Wound Healing


Open Wound
Open Wound  
QUESTION: I had a left side lumpectomy w/six nodes removed along with reduction & lift of both on Dec 21st. My right side healed great. Left side had issues where it looked as if stitches were coming apart. On two week check with doctor he gave me Silvadene cream to put on it. At three week check I was given Xeroform strips to start using instead. At this past Mondays four week check they did a debridgement, put me on Bactrim, and I'm back on Silvadene cream daily. Each day the area busts open even more. I'm concerned this could be getting very serious but they keep brushing it off saying "It will look worse before better". No one has even tested to make sure I don't have some sort of staph infection or something going on.  don't feel this is normal as it keeps opening more each day. Should I see someone else for a second opinion (Like a wound care clinic) or does this seem like normal wound healing?

ANSWER: Hi Candice.
I'm sorry you're going through this.
I presume you had radiation after your lumpectomy to complete your breast cancer treatment. Previous radiation significantly increases the risk of wound healing complications after surgery because it decreases the blood supply to the tissues.
Silvadene is a good way to clean up a wound. Your wound looks clean and I don't think infection is the main issue here. However, ruling out infection is never a bad idea and is easy to do especially if there is abnormal drainage.
At this point, consultation with a wound care specialist would not hurt. You could benefit from hyperbaric therapy which can greatly increase healing time especially in radiated tissues.
I hope this helps.

Dr C
PRMA Plastic Surgery

---------- FOLLOW-UP ----------

QUESTION: Hi - I have not had radiation - this issue is delaying my radiation. This is strictly a wound from surgery.

Ok, you had oncoplastic surgery on the left and a breast reduction on the right for symmetry.
As long as the pathology results from your surgery show clear margins (i.e. they got all the cancer), I recommend you consult with a wound care specialist for consideration of hyperbaric therapy. Hyperbaric therapy will significantly speed up your wound healing.

Dr C

Plastic Surgery

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Minas T Chrysopoulo, MD




Dr Chrysopoulo is certified by the American Board of Plastic Surgery and is an active member of the American Society of Plastic Surgeons (ASPS) and the American Society of Reconstructive Microsurgery (ASRM). Dr Chrysopoulo's areas of special interest include breast reconstruction following mastectomy (including DIEP, SIEA, TUG and GAP flap procedures, fat grafting, Alloderm one-step), and scar healing.

Certified by the American Board of Plastic Surgery.

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