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Open wound from DRAINING HEMATOMA after breast surgery. Treament?

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I have an open drain wound from a draining hematoma after breast surgery. It has been draining for 6 months now.  It has been under a bandage all this time.   I am afraid the drain hole is becoming necrotic at the bottom. Or COULD become necrotic because it is getting no blood. I've attached a picture which shows that it is grayish at the bottom. In real life it is worse than this--the skin looks whitish-gray and looks sort of dead. No circulation. Do you think this will BECOME necrotic (I know it is not necrotic yet).  By the way, the red in the photo looks much LESS red in real life.

Also, if this did turn into necrosis--it is only 2 mm by 4mm in size.  Would that have to be treated right away, or would it be safe to wait a month or two?

Category: General Surgeon

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Dr. Hari Charan Perigela
Category: Pediatric Surgeon
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 31 Doctors Online

Expert:  Dr. Hari Charan Perigela
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Hi Thank you for posting your query.
I saw the picture.
It is not necrotic at the bottom.
Routinely, the drain hole closes spontaneously once the discharge is stopped.
It will not become necrotic too.
Apart from blood,lymphatic fluid will also be discharging after breast surgery. It will take some time to regress.
If only blood is draining, you should take Tranexamic acid tablet twice daily.It has helped in some of my patients .
Hope I answered your query. If you have any questions, I will clarify further.
Wish you good health.

Regards


Patient replied :

Thank you. I am just wondering if with that gray dead looking area at the bottom, it could become necrotic in the future, even though it is not necrotic now? Did you see the gray area? It is really gray and white and looks sort of dead.
ALSO, is it unusual for a hematoma to drain for 6 months? Because after radiation, I got at least one hematoma and I have had bloody drainage for 6 months.


Expert:  Dr. Hari Charan Perigela
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Hi I saw the grey area.Chances of getting necrotic is less.Even though it becomes necrotic, you can get the necrotic area excised.It will heal.
Yes,it is unusual to get discharge for 6 months.
You should take second opinion from another Surgeon, get examined clinically and proceed accordingly.
Wish you good health.

Regards


Patient replied :

If a small area (4mm by 2mm) becomes necrotic, is it all right to wait 2 months before getting it excised? We are supposed to go to Africa at the end of July, and I am worried that it might become necrotic and ruin our trip. Thank you.


Expert:  Dr. Hari Charan Perigela
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Hi Eventhough some area becomes necrotic, you can wait for 2 months.
Nothing to worry.
It doesn't cause any problems.
If the discharge stops,the wound gets closed spontaneously in course of time with a scab formation.Once the scab has fallen,the wound will be clean and healthy.Necrotic area may fall with the scab.
Wish you good health.
Enjoy your trip.

Regards

Dr. Hari Charan Perigela
Category: Pediatric Surgeon
Experience: 
Fellowship: DNB, General Surgery, National Board of Examinations, New Delhi, 2001
Residency: MS, General Surgery, Sri Venkateswara Medical College,Tirupathi, 2000
Medical School: MBBS, Kurnool Medical college, 1995
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