What is the process for handling wounds from a breast reconstruction that are not healing properly?
By: Dr. Minas Chrysopoulo
This depends on the severity of the wound.
The most common type of wound healing problem we see is a superficial wound that develops because an area of the incision is slow to heal. Superficial wounds may just require antibiotic ointment and a dressing. Deeper areas of delayed healing are usually treated with more frequent dressing changes, usually performed 2 or 3 times a day.
Large wounds are thankfully uncommon. These may be treated with a special dressing called a "VAC". This is a sponge dressing that is replaced every few days (typically 3 times per week). The sponge encourages healing by applying mild suction pressure to the wound. The pressure is generated by a small portable device that the patient can carry around like a purse.
Large wounds can also require hyperbaric therapy. This essentially pushes more oxygen in to the wounds to encourage healing.
Surgery can sometimes also be required to ensure any unhealthy tissue that is preventing healing is removed from the wound.
Any identifiable patient risk factors for poor healing are addressed before the initial reconstruction but may need ongoing attention. The most common contributing factors are smoking, diabetes and poor nutrition. Smoking of course is an absolute "no-no". Diabetic patients must also be re-evaluated to ensure their blood sugar levels remain under good control after surgery. Regardless of the severity of the wound, it is also important the patient's diet is optimized to ensure the patient is eating enough of the nutrients required for normal healing (including protein, zinc, vitamins A and C).