Breast Surgery Coffs Harbour Health Campus

On this page: Preparing your skin for surgery | Looking after your wound after breast surgery | Common problems following surgery | More serious problems following surgery | Further information

Preparing your skin for surgery

Pre- Surgery Chlorhexidine (CHG) body wash/shower

Preparing your skin for surgery is extremely important, to do this, it’s highly recommended that you wash or shower with a Chlorhexidine (CHG) body wash before surgery.  Breast Care Nurses will provide you with the (CHG) body wash for free. 

Shower the night before surgery and the morning of the surgery for the best results. If you are allergic to CHG, the breast care nurse will provide Triclosan pre-op wash instead. If an allergic skin reaction occurs stop using the product and contact your breast care nurse for further instructions and/or your local doctor.

  1. Wash and rinse your hair, face and body using your normal shampoo and soap or body wash
  2. Make sure you completely rinse thoroughly
  3. Pour ½ CHG body wash liquid in your hand and apply to your entire body from NECK DOWN and rub for three minutes NB: DO NOT use this product on your face, hair or genital areas
  4. Pay particular attention to skin folds under the breast and the armpit area and avoid scrubbing your skin too hard
  5. Turn on the shower and rinse the soap off your body completely with warm water
  6. Do not use regular soap after washing with the CHG body wash
  7. Pat your skin dry with a freshly-laundered, clean towel after each shower
  8. Dress with freshly-laundered clothes after each shower
  9. It’s important the night before surgery to sleep with clean bed linen to keep your skin clean
  10. Do not apply any lotions, deodorants, powders or perfumes to your body
  11. Do not shave body hair with razors the night before or the day of the surgery
  12. Make sure you keep your hands clean.

Thank you for taking care of your pre-operative preparation at home to prevent surgical site infections post-surgery.

 

Looking after your wound after breast surgery 

Most women make an uneventful recovery from breast surgery, quickly returning to their normal daily activities. This leaflet gives you information about how to care for your wound after surgery. It describes the normal changes that occur following surgery and explains some of the possible problems that can arise. Following breast surgery, there is normally one wound in the breast.

Dressings

The wound will usually be covered by a waterproof dressing on top of steristrips (paper tapes). These dressings should remain in place until your postoperative appointment 7 to 10 days after surgery. You may shower as usual with the waterproof dressing in place. The wound is usually closed with dissolving stitches which do not need to be removed. Most patients do not go home with stitches that need removing.

Skin Care

The day after surgery, you may shower as usual and pat the wound dry using a soft, clean towel. Allowing the wound area to get wet in the shower will not cause any damage; in fact, keeping the area clean helps prevent infection and encourages healing. It is, however, better not to soak the wound area in a bath. Swimming should also be avoided until the wound has healed.

Drainage

During surgery, a drainage tube (drain) may be placed in the breast wound. This may be removed in the hospital before you go home; whereas at other times it needs to stay in for longer. If you go home with the drain in, you will usually have help looking after it. The hospital will arrange this for you, through the community nursing team. The drain will be removed at the appropriate time according to your surgeon’s instructions.

In some cases, it may not be possible to arrange community nursing and you will be shown how to look after the drain yourself. You will be asked to keep a record of the volume of fluid that comes down the drain each day. This is important as it will guide the decision as to when the drain should be removed. Breast care nurses will be available to advise you.

Exercise

It is important to perform the arm and shoulder exercises recommended by your doctor and physiotherapist. You should try to use your arm for normal daily activities, within the limits of pain, to prevent arm and shoulder stiffness. Wound healing is not delayed by doing arm exercises or by using your arm as usual. Some patients worry that exercising may ‘pull open’ their wound, but this is not the case. If you have a drain in place you will be asked to do your shoulder and arm exercises only to shoulder height until the drains are removed.

 

Common problems following surgery

Most problems arising from breast surgery are not emergencies. These can usually be treated by your community nursing team or your GP. If they have any concerns, they will contact your specialist or breast care nurse.

Pain

The day after surgery, you may shower as usual and pat the wound dry using a soft, clean towel. Allowing the wound area to get wet in the shower will not cause any damage; in fact, keeping the area clean helps prevent infection and encourages healing. It is, however, better not to soak the wound area in a bath. Swimming should also be avoided until the wound has healed.

It is normal to experience some pain after breast surgery. Usually the pain tablets recommended by the hospital will control the pain if you take them in the recommended doses. Some pain tablets can cause constipation. It is important to ensure you are having sufficient fluid during the day and that you are doing some gentle exercise. In some cases you may require a simple laxative. If you need advice about this, contact your GP or breast care nurse. If you experience an increase in pain after you go home, you may be developing problems with your wound. If this happens, contact your breast care nurse, GP or the hospital to have the wound checked and to get advice on how to manage the pain. Many women experience sharp stabbing like pains that do not last for long but can be concerning. This is normal after breast surgery. These pains do not require any special treatment and they will settle over time.

Bruising

Minor bruising around the wound is common after any surgery. More significant bruising will occur in around 25% of patients. Other than giving a dark appearance, which may change to a yellow colour, this is usually not a problem. Most bruising will settle without treatment as the body breaks down the blood collection over a 2–3 week period. A more significant form of bruising is a haematoma, which sometimes requires treatment. This is discussed later in this brochure

Wound Swelling

It is common to get some swelling or lumpiness along the edges of the wound. It may take 6–8 weeks for the wound to flatten out. This is early scar tissue forming and it is not a cause for concern.

Drain Leak and Drain Blockage

A blocked or leaking drain is an annoying situation. If the drain leaks simply wash around the drain site, apply a clean pad, and tape it around the drain. If the leak continues, call the community nurse or breast care nurse to obtain advice. It may be that the drain is blocked and may need to be removed earlier than planned. Once again, this is not an emergency.

Seroma

A seroma is a build-up of normal body fluid that often occurs after armpit (axillary) surgery. Although seromas can be uncomfortable and cause significant swelling, they are not dangerous.  Seroma can develop even after a drain has been removed at the “correct” time.

Stitches

The stitches in your wound are usually dissolving and do not need to be removed. The stitches are internal, but occasionally, part of a stitch does not dissolve and may partly come out through the skin. If this happens, the stitch needs to be cut and removed; you can do this yourself or ask your doctor or nurse to do it for you.

 

More serious problems following surgery 

If you think you may have any of these problems, attend the Emergency Dept of the hospital, contact your breast care nurse or community nursing team to have the wound checked. Your specialist may need to be contacted to review the wound.

Wound Infection

Wound infections occur in about 1 in 20 patients with a breast wound. If an infection develops, the wound usually becomes more painful. You may also see swelling and redness, and pus may be seen around the edges of the wound.

Rarely, you may feel unwell and develop a fever as a result of a severe infection. Wound infections usually develop over several days and are not emergencies. If you notice that the wound is becoming hot or red, or it becomes more painful, you should seek advice. Some wound infections require antibiotics and others may need the stitches removed to allow any collection of pus or fluid to be removed. If you are prescribed a course of antibiotics, it is important to finish all the tablets, even if the infection settles after only a few doses.

Wound Breakdown

Sometimes the blood supply to the edge of the wound is not adequate to allow proper healing. This is a particular problem for patients who are smokers. If this problem occurs, it develops gradually over several days and is not an emergency. If this occurs, the edge of the wound in one section or along the whole length of the wound changes to a dark red or purple colour. This can usually be treated with dressings to the wound. If you are worried about the edges of your wound you should ask your nurse or doctor to check your wound.

Haematoma

A haematoma is a collection of blood in the wound. It causes swelling and bruising of the wound. Sometimes a small amount of old (dark) blood can be seen leaking from the wound. Rarely the amount of bruising that occurs may require that the blood collection be removed in the doctor’s surgery or in the operating theatre. If you are experiencing severe swelling with bruising you should ask your nurse or doctor to review your wound.

IMPORTANT:  This information guide is designed to help you understand and discuss your treatment it is not a substitute for medical advice.  At all times you should rely on the expert judgment of your medical advisor(s).

Reference:  Westmead Breast Cancer Institute

Further information

Specialist Breast Nurse
North Coast Cancer Institute
Coffs Harbour Health Campus
345 Pacific Highway
COFFS HARBOUR NSW 2450

Tel:         02 6656 5702
Fax:        02 6656 5855