seroma burst after chemo

[lucy3]

My initial mastectomy and TRAM reconstruction was August 2007. The area which from the initial surgery has been painful, swollen and had difficulty draining is now a significant open wound which is being treated by a home health care nurse after repeated procedures (draining, debriding tissue, removing dead tissue) to fix it. Currently we are using a VAC on the wound and repacking dressings about every other day. I am still taking Herceptin. I have just started severely restricting activities. I have not yet had radiation and would like to know how to proceed regarding radiation treatment and the final surgery on the breast reconstruction. Thank you for any insights.

[lucy3]

Thanks. If I make it to that stage, I will be sure to get some! :)

[kuriosity]

How awful for you~

This is a complication for sure...  
Thing is- doing recon after radiation could have been a problem too
since implanting is not a sure thing on radiated tissue.
So maybe if you can get this healed up soon you'll be ok

I used cocoa butter on my breast after each radiation- It keeps the breast skin moist
and supple [had to wash it off good for next day treatment though]

[[hugs]]

[lucy3]

THanks for your reply. I appreciate it. The reconstruction was done at the same time as the mastectomy and I am worried I might lose it because of the wound that does not seem to be healing. THe seroma I had for about 10 months finally burst in April and even after several procedures to fix it, it is still not showing much progress toward closing.It's huge. I am wondering if there is a window of opportunity after finishing chemo in which one must start radiation for it still to be effective? I don't see how I can be healed enough to do the radiation by September 10 (the suggested start date my oncologist gave me). It is all very very discouraging, as I wasn't expecting to have all this open wound, pain, and forced inactivity once I made it through the chemo!
L

[PaulMD]

Hi there.

Radiation therapy would usually have local side effects on the overlying skin, usually drying, hyperpigmentation, and some scaling.  It is important to have the skin moisturized during the radiation process.  There can be some form of discomfort and pain from the radiation, however I think this is nothing your oncologists can't handle.

Reconstruction surgery would usually take place after the radiation (but this depends on the preference of the surgeon), since radiating a reconstructed breast can result to all sorts of symmetry problems and imperfections.

Make sure you are also well hydrated during the radiation process to keep the skin's elasticity in check.

Regards and God bless.