Had Wound Separation After Breast Reduction and Healing Very Slow with Infection, What Should I Do?

Thank you for the question.

Unfortunately what you are describing can occur after breast reduction surgery even in the best of hands. Wet to try dressing changes are an acceptable  method of handling this complication. Also, unfortunately it does take several weeks to months before the wound heals completely. Sometimes the surgeon may be able to close  the wound as it gets smaller in size.

I would suggest continued patience and compliance with your plastic surgeon.

I hope this helps.

This is the regimen that I follow. Secondary healing can be slow but healing cannot be rushed. Safe and steady will produce healing over time. If you are or were a smoker, have hypertension or diabetes, healing will be more protracted. Please continue to see your plastic surgeon regularly for followup to insure that healing is progressing appropriately.

Can happen fairly frequently in larger patients depending upon health and other issues.  Wet to dry dressings are a good way to get the old skin/tissue off and allow the new skin and tissue to grow in.  Healing this way however is very frustrating and long for the patient.  Do you have diabetes or are you a smoker?  These conditions will slow down or stop healing on their own, as will obesity, and a variety of medications and other medical conditions.  Also, do you really have an infection or do you have old liquefied fat leaking out?  Fat can look like pus, but it is not an infection, there is no heat or redness or increased pain in the area.  The best thing to do is to talk to you board certified plastic surgeon and make sure that you understand all of what is going on.  Dealing with difficult wounds and delayed healing is part of every board certified plastic surgeons training, we are the doctors that other doctors call in to help with wound problems,  and often the best course is clean up the wound and give your body the time and help it needs to heal the wound properly.  Good luck.

No one can ethically and accurately advise you on what you should do without examining you and knowing how your surgery was done and what was the cause of the wound separation.

If you have dead flesh in the breast, healing will start only after all the dead flesh was removed and clean living tissue was present on both sides of the wound. If the cause of separation is an infection, all pus needs to be drained, infected dead tissue must be removed and bacterial invasion (infection) must be treated with target accurate antibiotics which will kill the germs infecting you.

Unless you are malnourished or the skin was radiated, a clean separated wound should heal relatively quickly with Saline moist to dry dressing changes. If it slows down or stops you surgeon may need to check the wound for foreign bodies (dead flesh, old stitches, left behind gauze lint etc) or for a persistent infection which may need to be surgically drained.

A less troublesome way to handle complicated wounds is through the use of the VAC - a suction device which sucks on the wound removing bacteria which results in rapid turning and healing of complicated wounds. You may want to ask your surgeon if you would benefit from the VAC.

Peter A Aldea, MD