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The majority of women who undergo surgery for breast cancer experience a healing process free from complications or problems. Everyone heals at their own individual rate. Most physicians are more than happy for their patients to call with any concerns they may have about their surgical sites and discuss what the patient may perceive as a problem. There are some instances when calling the physician is prudent. These apply mainly to the first six to eight weeks after surgery.
“The majority of women who undergo surgery for breast cancer experience a healing process free from complications or problems. There are some instances when calling the physician is prudent.”
Redness around the incision: The incision line itself should be slightly red. This indicates the body is trying to heal the wound and is supplying blood and nutrients to the area. The area of redness should not be greater than about 1/2 inch and it should be uniform, not concentrated in one area. Keep an eye out for any area of redness that is increasing in size. The redness should decrease through the healing process, not increase.
Swelling at the incision site: The incision should be mostly flat. There will be some slight swelling immediately post-surgery just from the increased blood flow to the area and normal lymph fluid accumulation. This should decrease as the healing process continues. An area of increased swelling on the chest wall or in the underarm should be reported.
Fever: The majority of surgeons will include when to call about fever with their discharge instructions. A slight increase above 98.6 degrees Fahrenheit is to be expected. The body goes into a hypermetabolic state to produce the materials needed to heal the incision. This can raise the temperature slightly for a few days. An acute temperature increase of greater than 101 degrees should always be reported to the physician or his nurse. Be sure to report when it began and how long it has been elevated. Again, be sure to refer to the discharge instructions for guidance.
Drainage from the incision: There should be no drainage from the incision after the first dressing change. Be sure to note the color and consistency of the drainage when you call the doctor or nurse. Be sure to report any sudden drainage after the incision appeared to be healed.
Separation of the incision edges: The edges of the incision should be closed. If you notice that there is an opening anywhere along the incision, call your surgeon right away.
Drain dysfunction: The drains will remain in place for 10 to 14 days, or until the physician feels the drainage has decreased to a point where the drains are no longer needed. The drains need to have a vacuum seal to function properly. If they will no longer hold a seal, the surgeon should be notified. Likewise if no drainage is coming into the drain. There should be minimal drainage where the drain is inserted into the skin. Increased bleeding or other drainage should be reported. The color of the drainage should go from cherry red initially, to watery yellow-red, to watery pale yellow. Any thick drainage should be reported.
Pain: Pain and tenderness are expected for the first few days after surgery. Many women who have had breast surgery report that the pain is mostly gone after three days. The pain should subside and not increase. Prolonged pain or pain that is not relieved by the prescribed medication should be reported. A patient’s regular pain tolerance should be taken into consideration as well.
Change in odor: Normal healing tissue should be free from any strong odor. If the incision area or drainage from the containers takes on a strong or sweet odor, the surgeon should be notified.