Wounds are often closed with absorbable stitches, hence stitch removal is not needed.
Wound care is simple and patients will be taught and given specific instructions in the management of various types of wound coverage.
Patients are recommended to shower 2 days after most surgeries such as breast-conserving surgery and simple mastectomies.
Soft flexible tube drains are placed under the skin at the time of surgery. These help to remove blood and other fluids that accumulate at the site of surgery. Patients without breast reconstruction surgery are usually discharged from the hospital with the tube drain on the day after surgery.
The nurse in the ward will teach the drain care and provide a chart to keep a record of the drainage, to be reported to the Breast Care Nurse (BCN) daily. The drain will be removed in the clinic when the drainage is minimal and this usually takes 1 to 2 weeks.
Patients are recommended to see a doctor if there is:
Routine medications prescribed by doctors are usually resumed immediately after surgery and there are diet restrictions unless otherwise advised by the doctor.
Patients are encouraged to resume normal mobility and function as soon as it is suitable after surgery.
Most patients with breast-conserving surgery (BCS) and simple mastectomies will be able to resume usual daily activities immediately after surgery, with special precautions for those with breast reconstruction surgery, where management will differ according to their surgeries.
Our Arm Exercise Programme conducted by our Occupational Therapists or Physiotherapists on the day after surgery aims to prevent shoulder and arm stiffness. This will enable you to use the arm as you had before surgery in activities at home, work and in recreation.
The exercises also promote circulation of the lymphatic system, thus preventing swelling of the affected arm. Over-strenuous activities are to be avoided in the first few weeks after discharge.
These exercises are to be done once daily, and each set of exercises is to be repeated 5 times. Instructions from the Occupational Therapist or Breast Care Nurse on the limitations will be advised as needed.
Following axillary surgery, lymphoedema and increased risk of infection of the arm may occur as lymph nodes also contain cells which fight infection.
Therefore, extra care to protect the hand and arm on the operated side from injury is recommended.
Patients will be referred to a physiotherapist or occupational therapist specially-trained in treating lymphoedema. They will recommend programmes which include skin care, exercise, manual lymphatic drainage (a special massage technique), and compression garments to help reduce the swelling.
Preventive measures include:
You will be referred to an occupational or physio therapist for rehabilitation advice and arm exercise. Exercises may begin as early as the first post-operative day. The following basic steps can greatly reduce the risk of arm swelling:
Good skin care is essential in preventing an infection and subsequent swelling
Avoid extreme heat on affected arm pathway
Care for wounds, cuts or burns, and recognizing the symptoms of infection
Avoid any constrictions to the arm as this might restrict the flow of lymph fluid
On the operated side,
Maintain exercise to maximize lymph flow
Avoid overuse or fatigue of your arm muscles
With a mastectomy, physical appearance can be maintained by wearing a prosthesis (called a breast form), or by undergoing breast reconstruction.
There are women who choose not to have breast reconstruction after mastectomy. Some make this decision because they want to avoid extra surgery. For others, it is because they are comfortable with their appearance and body image.
Breast forms or prostheses are used to maintain appearance and a sense of balance, as well as to relieve the strain on posture that may occur after a mastectomy. They are available in a variety of sizes, shapes and colours. Some are designed to fit into a special bra. Others can be attached securely to your chest using a special adhesive.
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