Pressure sores are nearly always preventable—you are not likely to get any if you, and the people caring for you, understand what causes them and how to prevent them. You are in danger of developing pressure sores whenever you stay in the same position for many hours at a time, especially if you have lost a lot of weight. This is because when weight is taken by any part of you where there is very little tissue between the skin and the bone, the circulation to that part may be cut off. It’s not only your backside that is in danger. Pressure sores can develop on hips, knees, ankles, elbows, and even the back of the head—anywhere where there is bone very close to the skin.

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Following a mastectomy, you may be returned to the ward with a drip inserted into your arm. This contains a saline solution to replace the fluids that have been lost from your body during the operation, and will be removed after about 24 hours or when you are able to drink freely.

Drainage tubes

One or more small tubes will extend out of the side of the dressing covering your wound, each draining into a plastic bag or bottle, which will probably be placed beside you in the bed. Although the drainage system is cumbersome, you will be able to get up and move around the ward while it is still attached, but do remember to make sure the collecting bag(s) is supported before you do so. It may be taped to the.-side of your body or pinned to your nightdress. The weight of an unsupported bag will pull on the wound, causing discomfort.

During the first day following your operation, fresh blood and fluid will drain into the collecting bag. On the second day, the amount of fluid will probably have reduced substantially, and may be mostly clear, with a small amount of blood. Following a wide lump excision, the single drainage tube may be removed after about 24 hours. Each of the two tubes required after a mastectomy will be taken out when the drainage into them has reduced, which may be anything from 1 to 7 days after your operation.

The wound

Your wound will probably be covered by a clear dressing with an overlying pressure dressing to reduce bruising. The pressure dressing consists of a wad of gauze covered with Elastoplast strapping which is quite tightly applied after wide lump excisions and mastectomies. This will probably be removed after about 24 hours, once a doctor has visited you on the ward to check your wound.

If you do not want to be able to see the wound through the remaining clear adhesive dressing, do ask a nurse to cover it with gauze. You may find the sight of the blood-encrusted wound, the stitches and possibly some bruising upsetting. However, it will improve each day, and it should have healed and begun to look a lot better after a couple of weeks.

The wound may have been stitched with an absorbable material that will dissolve of its own accord in time, and only its ends may be visible. Alternatively, the stitches may be of a nonabsorbable material, possibly with a small white bead attached at each end. Stitches of this type will have to be removed 7 to 14 days after your operation. Many wounds are now stitched with a single continuous stitch, and appear as a single straight line.

The pull of the stitches may cause a feeling of tightness which will improve after a few days.

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