Postoperative wound: how to treat it

Good morning,

I’m writing on behalf of my daughter who underwent a breast augmentation on December 1.

The right breast wound never healed and there is a lot of space between the two stitches. She underwent an antibiotic susceptibility testing and it resulted positive to Staphylococcus aureus.

Following this test, she underwent a nearly 15 days treatment with tablets and creams that were locally applied. There is still a 4/5 mm distance between the stitches and it continues to leak although the wound doesn’t look red, swollen or stinking.

We asked for another antibiotic susceptibility testing to check if Staphylococcus aureus is still there and we are waiting for the result.

If possible, we would like to receive a consultation.

Thank you

One comment on “Postoperative wound: how to treat it

  1. Klarida Hoxha on

    Dear Vittorio,
    Thank you for your request. I’m really sorry for your daughter’s condition.

    During the latest years, we have treated cases similar to your daughter’s one and we obtained good results by following a therapeutic pathway that combines several therapies.

    This kind of wound can be classified as a surgical wound dehiscence that means a wound tissue destruction caused by a healing failure.
    It is a very common complication that can be due to several reasons and situations (to be analysed in your specific case). First of all, it is necessary to understand how much time has passed since the surgery and if the prosthesis is still there.

    As far as the wound, it is important to use suitable medications depending on the wound stage and the underlying tissue.
    It is important to understand the size and the depth through a soft tissues ultrasound in order to understand both the best pathway and medication. It is often necessary to use cavity dressings to favour the fluid drainage. If the fistula is not optimally drained it continues to produce fluid and this doesn’t allow the maintenance of a suitable microclimate to favour healing. If there is continuous exudate, this also favours the growth of bacterial colonies that find an adequate environment for proliferation. Besides the topical therapy which consists of medications, there is also the opportunity to reduce the healing times by using also an additional therapy named Negative Pressure Wound Therapy (TPWT).

    There are several types of therapies and in this case, considering the area where the wound appeared and its small size, there are also very small and easily portable devices that are flawless. It consists of a special medication that is sealed through a wrap to create an empty space and it is attached to a mobile-sized machine that works as a pump by exerting a negative pressure in order to keep the wound bed dry by managing the exudate in an optimal way. This favours healing as well because it sucks mechanically thus maintaining the stitches close.

    All this is combined with some HBOT sessions. HBOT is extremely useful because it has an anti-inflammatory and anti-oedema effect.
    If there is a lot of exudate, it is because there is a chronic wound. Its normal “healing” process consists of four phases: hemostasis, inflammation, proliferation and remodelling. The interruption occurs during the inflammation phase. It has an antibacterial effect and it works in synergy with the antibiotics enhancing their effect. It increases the tissue perfusion and it favours healing thus improving the fibroblasts, collagen, and angiogenesis synthesis.

    We remain at your disposal for any further need. You can call us at the number +39 0544 500 152.

    Best regards,
    Klarida Hoxha
    Head Nurse of the Wound Care Centre of the Hyperbaric Centre of Ravenna


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