Osteomyeletis to rib (Psuedomonas) after reconstructive surgery?

concernedSIL

Hello! This is my first post here. I found this forum as I started to search for information to understand my SILs treatment options. I work in healthcare but not specifically in oncology so please forgive me if I use the wrong abbreviations or terms. Here is the short version:

SIL (BRCA +, I don't know her specific type of breast cancer but otherwise perfectly fit and healthy) is about 6 years out from lumpectomy,chemo and radiation (right side). She underwent elective bilateral mastectomy at the end of August. She reported quite a bit of pain to one breast but was told it was normal after surgery, etc. etc. She developed redness and tissue swelling about 2 days after drain removal which was completed at her first post-op visit. She was admitted a few days later, cultures grew Pseudomonas, a PICC line was inserted and she was on IV antibiotics for a few weeks. Literally three days before she was supposed to have the PICC line removed she spiked a fever and was admitted once again.

Infectious disease MD and surgeon apparently did not initially agree on treatment (surgeon wanted to leave the expander in and just debride and stay on antibiotics; ID wanted it OUT) but the expander was eventually removed and found to be coated with now drug resistant Pseudomonas AND the infection had eroded posterior into her chest wall with a rib exposed. We learned today that pathology reports show the rib is indeed + for Pseudomonas.

Questions:

1. Has anyone here had this experience?

2. Should they continue with the same surgeon? There have been some awkward moments that I sense. I am not there with them but I personally am a bit baffled that the surgeon had a patient on the verge of sepsis/massive infection and yet he didn't want to remove the expander. This is concerning to me that he puts his work above her overall health if that makes sense.

3. Before they proceed, should any type of studies be done on the vascular health of her chest wall? The infected side is the same side where she received a lot of radiation. Could this not bode well for continued reconstruction attempts to that side?

I welcome any advice or thoughts!! Thanks for reading!