What happens if your doctor can't close you up after a mastectomy? Am I eligible for a flap and skin graft?
Doctor Answers 5
Chest wall necrosis
I am so sorry to hear about your post mastectomy problem. Debridement (removal) of dead skin is important for healing, but if the muscle is healthy, you are a candidate for a skin graft ( from anywhere on your body - generally your thighs or buttock) or a rotation skin/muscle flap closure of the hole.This can come from your back (Lattissmus) or abdomen. This will be much more comfortable for you and easier to care for. A wound vacuum ("vac") is easier than changing bandages multiple times a day over the wound but is somewhat cumbersome. If you do not feel your surgeon is offering you options, definitely seek a second or third opinion. You need to resolve this so you can get on with your life. Hopefully once the wound is healed you can proceed with actual breast reconstruction - as opposed to wound coverage, and return to a more normal life. Good luck and take care.
Wound closure after mastectomy
Wound healing problems after mastectomy can happen. Typically, when there is a large wound, wound care is performed with daily dressing changes or a wound VAC. More often, though, a flap is typically performed to close the wound and also shape a breast. Typically flaps are the latissimus dorsi flap (from your back) or a deep inferior epigastric perforator flap (from you belly). In my opinion, consult with your plastic surgeon about the next steps.
Manish Champaneria, MD
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Mastectomy skin loss
Best of luck in your recovery.
it is important to have the wound cleaned of all the dead tissue, debridement. Also no infection.
Then the treatment options are several
1: conservative wound care with wound VAC, and that will take 6-12 weeks to heal
2: If the tissue is healing well and no infection a skin graft would close the wound
3: best is to have no infection. Then debride all dead tissue and close with flap. either a TRAM flap or a Latissmuss Dorsi flap. On the long run a flap coverage is best and allow for future breast reconstruction if desired. Consultation with a Board Certified Plastic surgeon can resolve the issue fairly quickly
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