After 2 surgeries for breast cancer & breast reduction, I have large open wound with a lot of pain and is not healing. Advice?

I know this looks horrible to you but it's not as bad as you think. Necrosis of skin flaps in this type of reduction is not that uncommon. With good wound care and continued antibiotics this will heal. Unfortunately, this will take some time. Eventually, the tissues you are seeing at the base of the wound will turn into healthy red granulation tissue. Once that occurs t the skin will start to grow over the top and close the wound. Down the road the resultant scar can be revised. I personally prefer a normal saline wet-to-dry dressing over nonstick pads. This dressing can perform a small degree of debridement to facilitate wound healing. It may be uncomfortable and even painful during the dressing change and if  it becomes intolerable, then I would suggest to go back to nonstick. However i think the saline wet-to-dry dressing will speed up the healing process.

I recommend continued local wound care with a wet to dry technique. Moisten a gauze with water, allow it to dry in the cavity, then remove. With the gauze will come debris in the wound base. This will accelerate the wound healing process. Talk to your surgeon. Best wishes. 

It sounds like it has been a very difficult year, misafari.  The keys to treating most post operative surgical wounds is controlling the environment to minimize risk of infection, debridement of necrotic and compromised tissue, nutritional resuscitation, and quality wound care.  Close follow up and regular visits with your operative surgeon will be critical to getting the wound turned around as quickly as possible, as it may be desirable to change the method of treatment as the wound matures.  There are literally dozens of different means to treat an open wound, and the selection depends on wound site, quality of the tissue, nature of the injury, degree of contamination, etc... Once clean of debris, you may benefit from a wound vac.  If your surgeon is uncomfortable with wound care, or simply unavailable, you may want to consider a referral to a wound care center.  Best of luck with your continued recovery. 

Hello and thank you for your excellent question. I recommend that you follow up with your surgeon directly. We typically close these wounds surgically. Good luck!
Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc”