Post-Surgery Concerns: Managing Wound Issues After Adenoma Removal

Questions about the wound after adenoma surgery?

Hello, doctor.
I apologize for the lengthy description, but I appreciate your help! About a month ago, I underwent surgery for a breast tumor (approximately 2 cm adenoma).
The wound did not require stitches to be removed and was dry within two to three days with no other issues.
During my follow-up appointment after the first week, the doctor informed me that the wound was healing well and that it was safe to get it wet.
However, the day after the follow-up, the wound began to show some serous drainage (but there was still no redness, swelling, or pain).
By the second week, the drainage persisted and increased, so I visited a nearby clinic (not the original surgical hospital).
The doctor indicated that the wound was inflamed and infected, prescribing oral antibiotics and ointment.
After about three days of medication, a suture (the end of the thread) fell out from the drainage site, leaving a small hole about 1 mm in diameter, and I could see that there were still some non-absorbable sutures inside (it was quite deep).
In the third week, after finishing the medication, I continued to monitor the wound, which still has drainage (but there has been no redness or pain), and the small hole has not healed up to this day in the fourth week.
I would like to ask: 1.
Is this situation indicative of a reaction to the expelled foreign suture end, and what self-care measures can I take? 2.
Given the above, is it necessary to return to the hospital for further wound management? 3.
Considering that the small hole has not healed, should I continue to keep the wound dry in this situation? (Currently, I have not exposed it to water, and I use gauze to absorb the drainage, applying waterproof bandages while showering.) Thank you once again!

Azul, 30~39 year old female. Ask Date: 2020/02/26

Dr. Yu Mingchang reply Surgery

Hello; when you have time, please return to the original hospital for an evaluation by your original surgeon.
The Ministry of Health and Welfare Changhua Hospital is concerned about you.

Reply Date: 2020/02/26

More Info

Post-surgery concerns, particularly regarding wound management after adenoma removal, can be quite stressful for patients. Based on your description, it seems that you are experiencing some complications with your surgical site, specifically with persistent drainage and a small opening that has not yet healed. Let's address your concerns systematically.

1. Is the drainage a response to the expulsion of foreign material (suture)? What can I do?
The presence of drainage, especially if it is clear or slightly cloudy and not accompanied by redness or pain, can sometimes indicate that the body is expelling foreign material, such as suture material that has not been fully absorbed. This is not uncommon, especially with non-absorbable sutures or if the body has a reaction to the material. You should avoid manipulating the area excessively, as this can introduce bacteria and lead to infection. Keeping the area clean and dry is essential. If the drainage is minimal and the wound is not red or painful, you may continue to monitor it. However, if the drainage increases or if you notice any signs of infection (such as increased redness, warmth, or pain), you should seek medical attention promptly.

2. Should I return to the hospital for further treatment?
Given that you have a small opening that has not healed and is still draining after several weeks, it would be prudent to return to your healthcare provider for a re-evaluation. They may need to assess the wound for any retained foreign material or signs of infection that may not be apparent to you. A healthcare professional can also provide appropriate wound care, which may include cleaning the area, possibly removing any non-absorbable sutures, and ensuring that the wound is healing properly.
3. Should I keep the wound dry?
Yes, it is generally advisable to keep the wound dry, especially if there is an open area. You mentioned using a waterproof dressing while showering, which is a good practice to prevent water from entering the wound. Continue to use sterile gauze to absorb any drainage, and change it regularly to maintain cleanliness. If the small opening persists, your healthcare provider may recommend specific dressings or treatments to promote healing.

In conclusion, while some drainage can be normal post-surgery, the persistence of a small opening and ongoing drainage warrants further evaluation. It is essential to keep the area clean and dry while monitoring for any signs of infection. Returning to your healthcare provider for a thorough assessment will help ensure that your recovery progresses smoothly and that any potential complications are addressed promptly. Remember, your health and peace of mind are paramount, so do not hesitate to seek medical advice when in doubt.

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