Going home after total mastectomy and axillary node clearance surgery

How long do I need to keep my wound dressing in place for?

You should remove the wound dressing 48 hours after surgery.

Can I shower/wash as normal?

You should remove the wound dressing 48 hours after surgery.You can shower as normal but you should not soak the wound until it is completely healed.

Do I need to have stitches (sutures) removed?

The stitches in the wound are dissolvable and so will not need removal. You will have ‘steri strips’ covering the wound. These can be safely removed five-seven days after your operation.

How should the wound look and feel?

Bruising and swelling are expected following surgery. This will resolve but may take some weeks. If you are concerned about bruising or swelling, or it increases, you should contact the Macmillan Breast Care Nurse’s helpline on 01273 696955 Ext. 4111 and leave a message for them during working hours (Monday to Friday 9am to 5pm). They will usually return your call the same day.

If you are concerned about bruising or swelling between 5pm-9am and at weekends you should contact your own general practitioner ‘out of hours’ service or the Horsted Keynes inpatient ward on 01444 441881 Ext. 5686.

It is normal to feel ‘lumps and bumps’ around the incision: this is scar tissue and is part of the normal healing process. You may experience numbness or changes in sensation where the scar is. This is because nerve endings are affected during surgery. This is normal.

Will my arm feel painful?

The armpit and inner part of your arm may be quite sore for a while and may feel more sensitive than normal or even numb. This is because your nerve endings are affected during surgery and may last for several weeks. You should take the painkillers given to you when you leave the hospital if you have pain.

When should I start my arm exercises?

You should start your arm exercises the day after your operation (this is especially important if you are going to have radiotherapy since you will need to be able to fully raise your arm for this treatment). You should perform these at least twice a day until you have regained full movement.

How will I know if my wound is infected?

If the wound becomes red, inflamed or painful then this may be a sign of infection. If you are concerned and it is during working hours (Monday-Friday 9am-5pm) you should contact the Macmillan Breast Care Nurses on 01273 696955 Ext. 4111 and leave a message for them.

If you are concerned about possible infection outside of working hours (between 5pm and 9am Monday-Friday or at weekends) then you may contact your own general practitioner ‘out of hours service’ or the inpatient ward, Horsted Keynes, on 01444 441881 Ext. 5686.

How will I know if I have developed a ‘seroma’?

A seroma is a common occurrence and is a collection of serum (a straw-coloured fluid produced by all wounds) under the skin of the wound. If you notice a large, soft swelling under the scar you should contact the Macmillan Breast Care Nurses who will discuss with you whether you need to have this fluid drained. If you do need to have a seroma drained, this will usually mean that you will need to attend a clinic at the Park Centre for Breast Care. This procedure is simple and normally painless and is usually carried out by a Macmillan Breast Care Nurse or a doctor.

When can I return to normal activities?

You should avoid carrying heavy shopping or doing strenuous housework or other jobs with the affected arm for 4 to 6 weeks. You should be able to drive after about 3 to 4 weeks when you feel comfortable behind the wheel with your safety belt on and are able to perform an emergency stop. It is advisable to inform your insurance company.

You should increase your activity gradually but it is important to listen to your body and rest as much as possible.If you take part in keep fit or swimming you should be able to return to these when your wound has completely healed. The surgeon or Macmillan Breast Care Nurse Specialist will discuss this further at your post-operative appointment.