Doctor Said my Mom Would Be Left with an Open Wound Because of the Radiation?

Hello, My mom was diagnosed with breast cancer back in april .They were sucessful removing it and followed it with radiation. She has since developed a large hematoma which became extremely infected. Dr. told her that they have to do surgery, but because of all the radiation the skin is damaged and she'll be left with an open wound. Isnt that dangerous, because she can devolope another infection? Can skin graphing help in this situation? Also Dr.said her breast would be deformed. Im scared for her

Doctor Answers (3)

Doctor said my mom said my mom would be left with an open wound because of the radiation?

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Hello! Thank you for your question!  If the wound is present, proper local wound care should not have any danger. Certainly, further debridement, use of a vacuum sponge device, flap placement, or skin graft may be helpful or necessary. Follow your surgeon's instructions and ensure that the wound remains clean and taken care of. Afterwards, Contour deformities or asymmetry between size/shape of the other breast following lumpectomy and radiation may occur after everything settles and is not an uncommon scenario following lumpectomy. There are several options to ameliorate this and you should discuss your options with your plastic surgeon to determine which option would be best for you. It is recommended to wait approximately 6 months to one year after your radiation therapy is completed before considering any reconstructive procedure on the breast.

Typically, implants in the setting of an irradiated breast has higher rates of complication, including infection, wound complications, capsular contracture, etc. Many surgeons, including myself, have placed implants to improve symmetry in these instances with excellent results. However, if your deformity is a contour issue with a soft tissue deficiency, placing an implant beneath the breast may actually worsen the deformity as it is not addressing the issue to "fill" the defect. For such problems, it may be a wiser decision to consider fat grafting for smaller defects, where fat is harvested for another area of your body and then reinjected into the defect, thus adding volume as well as having the added properties of fat graft stem cells. Autologous flaps such as local tissue, TAP, or LDMF may be needed for larger soft tissue defects. Of course, reduction of the other breast to create symmetry is an option, or a combination of procedures on both breasts. Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 10 reviews

Open Wound after Radiation for Breast Cancer

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Open wounds are always a problem and should be closed as soon as possible. Even after radiation, a skin graft or secondary closure should be done as soon as the wound is clean and the infection controlled. An open wound until this time, when properly cared for, should not be dangerous to your mom. Both procedures, however, can be problematic and may require more than one surgery to complete. Once the wound is healed and the scarring has settled down she can consider breast reconstruction to match the two breasts.

 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast Radiation

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Radiated tissue heals very slowly. The radiation injury can be of varying degree.Adding the hematoma does not help the radiated tissue healing. If there was infection, that need to be controlled then one need a thorough assessment of the tissue and the degree of radiation injury.

Though we do not know if yor Mother got a lumpectomy and radiation or a mastectomy and radiation. Once the infection is controlled then a Ltissmuss dorsi flap will bring good amount of blood supply to the radiated tissue and the chances of healing is much improved. The Latissmus dorsi will also help with the breast deformity and final reconstruction.

Samir Shureih, MD
Baltimore Plastic Surgeon

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.