Post mastectomy surgical site opened up massively

JillGalusha

Hi. I had stage 1 a breast cancer in the right breast. It was only 4mm. I decided to have a double mastectomy rather than a lumpectomy for personal reasons. 6 weeks after surgery I am having severe complications on the right side. This is what happened. April 14 mastectomy. About a week or two after the right side opened up at least 4-5 inches wide and about 1/2 in depth. There was one hole near the center and I don't know how deep it was. I panicked and went to plastic surgeon who said we see this all the time. Don't worry let it air out and it will heal from the inside out. I felt stupid panicking. week or two later woke up with blood all over my nightgown and sheets. Panicked again and saw plastic surgeon who said it was no big deal and he had seen this before and it would heal from the inside out. At this point he wanted me to pack it with moist gauze and cover it. Felt like a dumbass again. A week or two later I was standing in the bathroom when suddenly at least 1/4 to 1/2 cup of clear yellowish drainage came out all over me and pooled on the floor. Panicked again. Saw plastic surgeon and he said that was good and just continue packing it twice a day. I felt like a dumbass again. A week or two later I smelled this horrible smell and thought I needed to take the trash out but when I went to change the dressing I discovered it was my wound that stunk horribly. Panic again. Saw plastic surgeon who said I don't smell anything now. I REALLY felt like a dumbass. Why would I make up something like that? Anyway, he looked at the wound and at first said he would have to go back in and remove the expander because it was exposed. I freaked out. Then the massaged around the perimeter of the wound and suddenly a large amount of drainage spit out over him, me and the floor.He cleaned it up and changed his mind. He didn't think the expander needed to be be removed. Once again he said just pack it with saline soaked gauze and cover it. I never really saw what the wound looked like then.

When I got home I saw the wound had opened up all the way and I could see muscle tissue. Again keep packing it twice a day. It has now been six weeks since the surgery and I have a giant gaping deep wound and all I keep getting is pack it twice a day and it will heal from the inside out.

I am beginning to question my plastic surgeons judgement> My husband and I got into a fight over this. "Are you calling the Dr a liar? and do you think you know more than the doctor?"

Several years ago I had a lipoma removed and had to go to a wound care specialist for a couple of months. The treatment was brutal and painful but the wound did finally heal to a point where the doctor could suture it up. I found out that the rule of thumb is that if a wound does not heal on its own after a month the patient should see a wound specialist. If I just continue packing it twice a day I believe it could take at least 9 months to a year to heal on its own. THEN scar revision THEN heal again THEN begin filling expanders. It just doesn't make sense to me that it keeps getting worse but Im told to just let it heal from the inside out. In the meantime, I have resorted to using a female mini pad to absorb the drainage because the large open wound weeps all over my clothes.

Does this sound normal to you? Please be honest with me. Should I get a second opinion and go to a wound care specialist and piss of my plastic surgeon or accept that it might take 9 months to a year to heal on its own? I really need your advice. I want to move on with my life. Cant lift more than 5 lbs. Cant swim or fish or do many other day to day activities. Advise me on what I should do.

Lily55

I would definitely go to a wound care specialist.  I had  huge problema after a fat transfer got infected and was in hospital for a week with litres of fluid being flushed though the open tissue to keep it clean, it did heal but only with special packing to absorb the fluid.    I definitely think you need specilaist attention, it may be that you naturally are a poor healer but I would not wait any longer....I think you know this yourself but just want some support so please go and do it.....this does not sound right at all. 

Kicks

At this point with a large open wound that has progressively gotten worse for 6+ weeks - an appt with a Wound Care Specialist is more than in order. I'd have been to one probably at least 4 weeks ago. Especially if I had had a surgery in the past that had required a Wound Care Specialist as you say you experienced with a surgery to remove a lipoma.

I would also be finding a new Plastic Surgeon ASAP! Based on what you have said - that 'person' would NEVER touch me again. One who is well versed in corrective surgery.

I can't begin to comprehend what you've been put through. I did have an area (about 1") open up about 2 1/2 weeks after 2nd C-section. Called my Dr and was told to get in as fast as I could safely. Within a 1/2 hr of getting to the hospital I was up in a room and TX starting. Spent 2 nights there and went home with instructions to flush it 3 times a day with hydrogen peroxide and then flush with saline and to call immediately if any negative changes or if after hours - go straight to ER. Also told he wanted to see me in 2 weeks but it was Christmas time and Hubby had leave and we were going home so was told to be sure I saw a Dr there - I did see the GP who I'd seen for many yrs. It did heal fine with no more issues.

My other suggestion is to - document, Document, DOCUMENT everything. Use your Smart Phone to get pictures now and as 'it' progresses (even as healing developes when it does). This will prove exactly how/what it 'looks like' factually. Not just your words but visual proof that is undeniable.

Have you seen an LET (LymphEdema Therapist) yet? This is a good idea to do after an surgery to get a baseline evaluation and education. With all the issues you are having it would definitely be a good idea.

I understand not swimming with an open wound but do not understand why you can't fish.

(If you would fill out your 'Profile' here it would help with the replies to be pertinent.)

MinusTwo

I agree with Kicks. Don't walk - run away from this doc for a second opinion or to a wound specialist. Do it today. Do you have a breast surgeon that you trust? Or a Gyn doc? You could get references from them.

macb04

Sorry to hear about all of this, but your current PS sounds inexperienced, and frankly nuts. This is known as cellulitis. You may have a bacterial infection which will prevent healing until it is dealt with . If the bacterial infection were to spread into your bloodstream you could become quite sick with sepsis. Get to a wound care center or find someone in your area who can recommend a different PS, a competent PS. Do that ASAP. You could even go in via your local ER and they would probably admit you to the hospital for care. Where do you live?

Kicks

"You have a bacterial infection"

NO ONE here can diagnose anyone!

Artista928

OMG. Lose that ps now and inform you bs of your problem and get a referral to a wound doc. I wouldn't be surprised if it is infected. I had a tiny hole happen at my suture line last month this far out on my overly rad breast and my ps is very aggressively treating it first with abx and now with stitches. If it didn't close up on it's own when he takes the stitches out a week from Mon, he's going to take the implant out. Call first thing on Mon and get the ball rolling. I would also review the ps everywhere you can to hopefully save someone else from this subpar care. Wow. Best wishes. xxx

wrenn

Wow, you are stoic. No way I could have handled that. I agree with all of the above except the diagnosis of cellulitis and bacterial infection. Even a qualified physician could not diagnose that from text.

Let us know what wound care person says. Hope it improves quickly

Moderators

It really sounds like another opinion would ease your concerns, and possibly provide you with a better solution to your issues. Wishing you a resolution, so you can carry on with the things you enjoy!

macb04

I think that the following sentences by JillGalusha "A week or two later I smelled this horrible smell and thought I needed to take the trash out but when I went to change the dressing I discovered it was my wound that stunk horribly" and

"suddenly a large amount of drainage spit out over him, me and the floor.", led me to the statement about infection. Obviously she needs to be seen for the correct diagnosis and treatment ASAP.