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Wound healing after reconstructive surgery and radiotherapy.

8 REPLIES 8

Re: Wound healing after reconstructive surgery and radiotherapy.

Oh my goodness Josiejo, yet again?

Have they done blood tests? I'm not a medical professional but there must be some underlying cause to prevent you from healing properly.

I would want to explore an alternative opinion if I was you, but I don't know who from. Obviously chemo reduces your immunity and healing, how long ago did you finish? Has your "good" side healed well? Do you/did you smoke? What's your diet like? Are you otherwise fit and healthy?

I am so sorry you are going through all this. Have you called the helpline or Macmillan to see if they have any words of wisdom? There must be someone who specialises in skin/wounds/immunity/infection......

Have you tried the Someone Like Me service? You may get some help there.
Keep me posted with your progress.

Xxx

Re: Wound healing after reconstructive surgery and radiotherapy.

Thanks for your message Dawn. I have since had the second tissue expander removed due to the fact that it wasn't healing and the expander started to show through the wound. I am a week post op and my wound is angry red and seeping liquid of a watery punky, yellowish colour.
I am so fed up with it all.I am even considering going flat. However my boobs were big and I am still fairly young and single too!
My plastic surgeon is amazing, but I wonder if it is worth getting a second opinion? I don't know what you think?
Just completely fed up with the whole ordeal which seems to be never ending.

Re: Wound healing after reconstructive surgery and radiotherapy.

Sorry Josiejo, I've only just seen your post. 8 months is a long time with an open wound. You must be really fed up. I had a problem with wound healing, but not for as long as yours.

I had my mastectomy 3 years ago with immediate implant reconstruction. The wound was very slow to heal and I had to have fluid aspirated several times. The wound hadn't healed completely when I started chemo and it got infected, the skin broke down and I could see the implant through the hole. I had to have the implant removed, then had an expander inserted after chemo, before rads. The wound opened again during rads so had some saline removed from the expander to allow it to heal. It did heal well then despite the rads and I had permanent implant 8 months later (march 2016), which was replaced within 24 hours because of a large heamatoma.

I am not surprised that you are exasperated by all this. You wrote you post a month ago, I hope there's been some improvement???

Wishing you well
Dawn x

Re: Wound healing after reconstructive surgery and radiotherapy.

I have had an open wound that won't heal for about 8 months now.
I have a triple negative ductal carcinoma. I had cancer 10 years ago when I was 34 and was treated with breast conserving surgery and chemo and radiotherapy. My cancer returned in the same breast and location last year. I had genetic testing and found out that I carry the brca1 gene. Because of this I had a double mastectomy with immediate reconstruction using tissue expanders.
After about 2 weeks I had an infection and my expander on my cancer side was removed. Following this I received chemo and the wound didn't heal. After the chemo ended it still hadn't healed after a couple of months.
I was seen by the lead surgeon who referred me to a plastic surgeon. He arranged immediate hospital admission and I was treated with a vac pump dressing which required a series of 5 operations during my 18 day stay in hospital. I was discharged from hospital with a new tissue expander in situ with strattice grapht.
I have been home for 7 weeks and my wound still hasn't healed. I had surgery on Friday to correct a tiny area that hadn't healed and my plastic surgeon has completely reopened and re stitched my wound. I have about 8 stitches and feel like I am back to square one.
This is now 8 months with an open wound that won't heal.
I am completely exasperated by the whole ordeal and am wondering if anyone else has experienced a similar thing? I am 44 years old.

Re: Wound healing after reconstructive surgery and radiotherapy. Possible infection?

Thanks Ladies. Good to learn from people's experience. 

It does sound like wound healing can take some time after radiotherapy. Two of the points of leakage have healed up but one continued to leak. The skin then got infected and I have had to go on my second course of anti-biotics. Within 24 hours it had healed up again. BUT. My surgeon now suspects that there may be an infection inside. No fever, redness, or pus, but he is not hopeful. 

I am 7 weeks after surgery and he was offering to take it out this week which alarmed me! 

And to add to the issue, because this was a replacement expander after the first one leaked, my skin is now stretched too thin to have a third one. So I have no idea of whether I can ever have reconstruction!!!

As you can imagine I am full of feelings. 

I have decided to finish the course of antibiotics and then see what happens. But I am feeling a bit down about it all. 

Re: Wound healing after reconstructive surgery and radiotherapy.

I had radiotherapy after wle 6 years ago.

 

12 weeks ago i had mastectomy and scar is still not fully healed. The end of scar under my arm that is out of rads area, closed within 3/4 weeks. But front is a different story.

 

I had cellulitis 4 weeks after op and have had a lot of leaking yellow fluid. I am told slow healing is due to damage from previous radiotherapy. I have to keep putting off my appts for prosthesis fitting as they wont do it until fully healed. It is getting there slowly, but still have 2 areas that are open and leaking. Seems to be taking forever to close over and I cant believe its still like this. Glad to read Im not the only one.

Re: Wound healing after reconstructive surgery and radiotherapy.

I think this is probably different for each person.  I had rads in 2007, and then an LD flap with implant in 2010, with no heaing problems, or any other problems.

Re: Wound healing after reconstructive surgery and radiotherapy.

Hi Mariacpdb,

I had a left mastectomy with LD flap and strattice mesh and an expander implant in July 2012. As I had previously had radiotherapy 5 years before the surgeon did quite a large skin graft as well. I came home after five nights in hospital with two of my three drains still in, and I had someone stay with me for two nights. Just as well, as the first night one of the drain bottles lost vacuum and we had to go back to the hospital in the middle of the night. I had seromas drained each week after the drains came out for four weeks, and bizarrely during this time fluid would leak out of the entry point of my donor site drain, so needed to wear old tops and t-shirts! It took nine weeks to heal, the donor site being the last to finally close, but I suspect I'm quite a bit older than you. Driving was quite hard, I had a manual then and it really made my arm ache, but I drive mostly in town. Anyway a year later I had the expander replaced by a permanent implant and its all settling down nicely. Finally in January this year I had a reduction and uplift on the good side,
It's a long process, but it is possible after radiotherapy, but everything takes a bit longer. The filling of the expander implant had to be done over about 5 months to stretch the skin very slowly.
All the best with your future treatment - it will be worth it!
Jojo

Wound healing after reconstructive surgery and radiotherapy.

Hi everyone, 

I had a tissue expander recently replaced after it leaked.  Then i got a skin infection which was not picked up straight away.  The wound seemed to be healing but 3 weeks after surgery I started to get some serous fluid leaking and the skin slightly opened up. They then swabbed and gave me antibiotics to make sure it was not affecting inside.  The skin has healed and I feel fine.  The wound looks OK but occasionally I still keep getting a small amount of fluid leaking.  I am told this can happen at weak points until they heal. Having had radiotherapy 15 years ago on this side I am told it can take 6-8 weeks to heal- and I have had six weeks. No sign of infection and the wound looks OK. Just a bit disappointing and worrying. Has anyone else experienced this?    

Luckily the other side never had radiotherapy and has had no problems so far. But I wonder about how much the radiotherapy will continue to affect treatment on the radiotherapy side. Has anyone had reconstruction after radiotherapy succesfully? 

The technique I am going to have is building up layers of fat through injections from my tummy into pectoral muscles. Has anyone had this? I just worry that the radiotherapy may have compromised my chances for any reconstruction!

Thanksmariacpdb