How Can I Speed Up the Healing of an Open Spot After Breast Reduction?

Question

I'm 5 weeks post surgery and I have a small open spot on the incision line on my right breast. The area always has a litte bright red bleed. Itdoesn't appear to be infected. I have been keeping it clean with soap and water and applying an antiboctic cream and covering it with a pantyliner (gauze always sticks to the wound). I just need to know is there something else that I should/could be using to help speed up the healing? Is Silver Nitrate something that will help assist with the healing?

Eric Pugash, MD · Answer

Your open spot will heal - you cannot keep it from healing - no matter what you do or don't put on it.

	There is really only one frequently-seen cause for a wound not to heal: the presence of sutures at the site.

	When dissolving sutures become exposed and contaminated they will cause drainage and will keep the wound from closing.

	See your surgeon to make sure a suture below the surface isn't keeping the open area from closing.

	Good luck!

Richard J. Bruneteau, MD · Answer

It’s not
unusual for patients to suffer small areas of incisional breakdown following
breast reduction surgery.This is often
related to small absorbable sutures protruding through the incision.In many cases they become secondarily
infected and may require antibiotics.The vast majority of these wounds
heal on their own.They form a layer of
granulation tissue which is covered by new skin.Ocassionally healing is
delayed.This is almost always secondary
to suture remnants left in the wound.Under these circumstances, removal of the suture, local wound care and
dressing changes almost always solve the problem.In this situation silver nitrate isn’t
indicated.

Jeff Angobaldo, MD · Answer

Thank you for your question.  Difficult to answer without a photo.  The area that may be concerning you is the inferior T junction of a breast reduction.  This is the area that has the highest tension and least amount of blood supply in a breast reduction closure. It is an areas that can break down causing a superficial wound. Please see your surgeon for his wound care recommendation and follow his instruction.

Martin Jugenburg, MD · Answer

When there are small areas that take a little longer to heal, the best thing to do is to keep them clean and moist. Vaseline is great. Silver nitrate is used for wounds that are stuck and not progressing. It irritates the wound. Irritation makes things worse in a normally healing wound so unless your surgeon feels that there is a need for it, avoid using silver nitrate sticks.

Sincerely,

Martin Jugenburg, MD

Sincerely,

Martin Jugenburg, MD

Steven Turkeltaub, MD · Answer

Most probably you have a deep suture coming through the skin which is impeding full healing. You should contact your plastic surgeon who can inspect the area and make the appropriate recommendations which may include removing the suture if one is present. With removal of this suture, healing should be very quick.

Peter E. Johnson, MD · Answer

We tend not to see open areas after a short scar reduction, though a few at the 'T" of a very large reduction occur,often beginning with a spit suture. This will sound like heresy, though after many years of practice we have found that daily cleaning with soap and water and a dry cover, no ointments, produce the fastest healing. I know it is not the typical answer, no xeroform, bacitracin, etc., just cover it, telfa if things stick, but the open spot will close.
	Best of luck,
	peterejohnsonmd

Jonathan J. Staiano, FRCS (Plast) · Answer

It is common to have small areas that can be slow to heal, following breast reduction.  I would not advise silver nitrate, I reserve this for wounds that are overgranulating (florid, red, raised wounds).  You simply need to keep it clean and use a non-stick dressing.

	It is important to stay healthy and maintain a good diet and keep a positive outlook as I think this will be of more benefit than any topical dressings.  Good luck.  Jonathan Staiano

Tom J. Pousti, MD · Answer

It sounds to me like you're doing all the right things. &ldquo;Small open wounds" do occur after breast reduction surgery and may take several weeks/months  to completely heal. Sometimes removing a slowly dissolving stitch (foreign body&rdquo; may allow the world to heal more quickly.

	My only other suggestion would be to use sterile non-stick dressings (for example adaptic or xeroform)  as opposed to the panty liner.

	Silver nitrate is probably not necessary at this time (maybe use for over&ndash;exuberant granulation tissue).

	Keep close follow-up with your plastic surgeon.

	Best wishes.

Robert M. Grenley, MD (retired) · Answer

I would suggest keeping it clean with soap and water as you are doing, keeping it "greasy" with an antibiotic ointment (I tend to prefer the ointments rather than the cream as you are using, but it may not make any difference) such as bacitracin or polysporin, using a non-adherent material to cover it (such as xeroform or adaptic or a telfa pad), and wait for it to heal. Signs of infection would be increasing redness of the normal skin surrounding the open area.

How Can I Speed Up the Healing of an Open Spot After Breast Reduction?

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