Post operative information - Mastectomy

Care of your wound

  • Your wound will be covered with a waterproof dressing.  This will still intact until your post-surgery appointment.

  • You may notice some dry blood under the dressing.  This is very normal and is actually helping your wound heal. 

  • You do not need to do anything special to your wound whilst the dressings are in place.  After the dressings are removed Dr. Green will advise you of various treatments to decrease scarring.

  • You will be provided with more information about Creams and Tapes for your wound at the post op appointment

For more information about wound care click the link below

Stitches

  • Your wound has been closed entirely with dissolving sutures.  These will take several weeks to completely dissolve. 

  • You will not need to have any stitches removed after your surgery.

Drains

  • A drain will be placed at the time of surgery.  This is important to remove fluid that is produced from the skin and tissue after surgery.  If the drain were not in place this would build up and become uncomfortable.  This is called a seroma and would require needle drainage.

  • The nursing staff will teach you how to look after the drain and provide you with spares drainage bags and a carry bag.  Any problems with call the Ward directly (after hours) or Dr. Greens breast care nurse (0428197923) Monday -Friday from 9am -5pm

  • You will be shown how to record how much is coming into the drain.  It will initially be a large amount of red/yellow fluid.  Once it is less than 50ml on two consecutive days the drain will be remove. On average this takes about 1 week, although in some cases it may be 2-3 weeks.

  • If you accidentally pull your drain out DO NOT PANIC.  Nothing bad will occur, just cover with a bandage.  Let the ward our our nurse know and he will arrange for the fluid that builds up to be drained.

Signs of Infections

  • Bad Infection is a rare complication after a mastectomy. However, it is possible for as small infection to occur that can be easily treated with tablet antibiotics.

  • It is normal for the wound itself to look red.  However if the redness is Increasing past your dressings you may have an early infection.

  • If you are concerned notify Dr. Green or contact your GP who may commence you on a course of tablet antibiotics.

Pain Relief

  • Post mastectomy is not usually very painful. 

  • Most people can manage with simple analgesia (paracetamol) and anti-inflammatory (Nurofen). 

  • Some people do require some stronger pain relief and this will be provided at the time of discharge as required.

  • Very strong pain relief like Morphine and Oxydodone (Endone) is usually not required and actively avoided if there is not severe pain

  • Avoid constipation whilst taking the pain relief.  You should see your Pharmacist for some coloxyl and senna or Movichol whilst taking pain relief.

Showering and deodorant

  • Your dressings are waterproof and it is perfectly safe for you to have a shower after your surgery. 

  • When you have finished your shower just pat your wound dry. DO NOT use hair dryers as you will burn your skin

  • Deodorant (aerosol deodorant or roll on) is perfectly safe to use after you surgery.  It is best to avoid powdered based deodorants.

Driving

  • You will NOT be able to drive for 48-hours post surgery whilst your surgical drains are in place

  • It is essential you still wear a seatbelt post surgery.  A pillow will be helpful to protect your wound.

  • Clearance to not wear a seatbelt WILL NOT be given

  • To safely return to driving you must be able to have full movement in your neck, chest, shoulders and are not be inhibited in anyway

Return to work

  • You will need to have some time off work after your surgery.

  • Usually 2 weeks is the minimum

  • Dr. Green will happily provide a medical certificate for these times if you wish.

Energy levels and resuming normal activities

  • It is normal to not have full energy levels after the operation. 

  • You should be able to perform usual light duties within 1 week of the surgery.  Although it is quite normal to not regain full levels of energy for several weeks after an anaesthetic. 

  • Regular light exercise (walking, riding etc...) is encouraged after your surgery.  A basic rule is ‘if it hurts its to strenuous and you should stop’

  • Regular exercise is important.  There is good evidence supporting exercise and healthy eating in terms of your breast cancer treatment.

  • Whilst your drains are in place your arm use will be limited and details will be provided by our Physiotherapy team.

Follow Up

  • A post op appointment will be arranged for you around 1 week post your surgery.

  • Please check this appointment and if it is made on a day that is not suitable please call the rooms to arrange an alternative.

  • It is essential that you are seen within 7-10 days post surgery

  • Phone consultations are NOT appropriate for post operative appointments

Information specifically for Axillary Lymph Node Surgery

Sentinel Node Biopsy

  • The blue dye used to find the node will make your Urine blue for a day.  This is normal and not dangerous. It will also give you a grey complexion for 24 hours but will pass.

  • No additional post surgery care is required.

  • There is NO NEED to avoid blood tests or blood pressure taking from your arm after a sentinel node biopsy.

  • The very small risk of lymphedema will be monitored by Dr. Green.

Axillary Clearance

  • You will have an additional drain in place after and axillary surgery.  You manage this exactly as you do for your mastectomy drain.

  • An axillary clearance is often more uncomfortable and you will be given stronger pain relief.  It is important to avoid becoming constipated while on these medications.

  • Physiotherapy will be started whilst you are in hospital.  You will be given a number of exercises to do.  It is STRONGLY encouraged to continue these exercises whilst at home.  It will help in the prevention of lymphedema.  If necessary additional physiotherapy can be arrange when you return for your post surgery appointment.

  • Shoulder movements.  It is perfectly safe to raise your arms above your head.  You should not restrict any movements. 

  • Lymphedema will not develop overnight. Early swelling is most likely secondary to the surgery and fluid you where given.   Dr. Green will monitor you for signs of lymphedema and if it begins will arrange expert lymphedema care immediately.

  • There is no need to avoid blood tests or blood pressure taking from your arm after an axillary clearance.  These only need to be avoided if lymphedema occurs.