Post-mastectomy care involves more than specialty
undergarments and
breast prostheses, and fitters must be aware of other issues
that concern these patients. As with virtually all surgery, mastectomies carry
the risk of
scars that are both unsightly and traumatic.
In the past, post-mastectomy scar management has been mostly
nonexistent.
“The main concern, as it should be, was to make sure affected
tissue was removed,” Brigg Ett Jordan, director of North American sales in
the medical division at Silipos in New York, said.
The surgical process, however, can cause folds of skin that damage the
skin’s smooth surface, causing scarring.
“Many women do not know where to turn for help in this area and
rely on their pharmacist’s advice,” Jordan said. “Many studies
have shown that the key to successful scar management is moisturization and an
occlusive environment.”
Lotions and creams provide the necessary moist environment for healing,
she told O&P Business News, however, the rate of evaporation
requires constant reapplication and the use of some type of covering, such as a
plastic wrap, or silicone or gel sheeting.
Once cleared by the physician, patients should contact an occupational
therapist to receive instruction on how to perform massage therapy for up to 3
months after surgery. Massage for post-mastectomy patients can be used on any
scar that is completely healed, and consists of softening and flattening the
scar on the skin’s surface and sliding the skin’s tissue layers over
each other.
Massage also helps to rebuild the collagen in the skin; stimulate new
tissue growth; reduce tightness and pain in any scar; increase complete healing
and scar fading, tissue sensitivity and localized circulation and neurological
function; and improve scar appearance, reducing redness and swelling.
Scars are not just an aesthetic concern, and proper treatment limits
additional complications in the future.
“Addressing the scarring issue in the post-mastectomy patient is
critical for a number of reasons,” Jordan said. “In particular, it
provides comfortable fitting and wearing of breast forms and bras — if a
scar goes untreated, this may cause daily irritation — and, the overall
appearance and well being of the patient.”
She recommended sending patient care information to physicians to
educate them about addressing scar management and open the dialogue for future
referrals.
“Addressing the issue of scar management in post-mastectomy
patients brings the breast care professional to the forefront in taking care of
all needs of the patient when fitting prostheses,” she said. “It is
giving the patients information and choices.” — by Stephanie Z.
Pavlou
For more information:
With the increase in breast cancer among all women there are many
aspects that need to be addressed with the patients’ post-mastectomy care.
It is important to address issues such as scar management. Physicians take care
of their part, such as the surgery and making sure all the cancer is treated
with the correct protocol; it is the job of the certified mastectomy fitters to
follow up on the patients, not only to fit them properly with post-surgical
garments, but to make sure that they are healing properly with regard to their
scars.
There are topical products that will help with this, but more important
would be the scar reducing techniques so they do not develop any problems with
their surgical sites. Scar reducing techniques should include light stretching
and massaging of the scar area and should be performed during the first year.
If this is not done there is an increased chance of the patient [experiencing]
pain and tightness at the surgical site, which can affect them in wearing any
garment. The massage technique will cause the patients’ scar tissue to
heal in a healthier pattern and eliminate tightness and constriction. Physical
and occupational therapists who specialize in this will use vigorous, deep and
soft tissue massage to relieve pain and unusual tightness at the surgical site.
By increasing the patients’ awareness to how their surgical sites
should feel and look also will help decrease their chances of developing
lymphedema. Patients will be much more in tune to their bodies and will be much
more aware of any scar that is not healing properly. So the job of certified
mastectomy fitters is not only about the prosthetics, but the overall
management of the surgical site and educating their patients on what to be
aware of with regard to their scars and [the] affected area.
— Lisa Lindenberg, CMF
Boutique
coordinator, Sanofi Aventis Wellness Boutique