Modified Radical Mastectomy (MRM)
Modified Radical Mastectomy aims to provide information about the procedure you are about to undergo and the pre-operative, intra-operative and post-operative instructions you are advised to follow for an event- free and quick recovery.
PRE- OPERATIVE PROCEDURES:
Prior to the surgery, you will be required to undergo a set of tests for assessing your fitness for the procedure. An MRM is routinely carried out under General anaesthesia, unless you are unfit for the procedure, in which case, suitable anaesthesia will be used. You will be seen by a physician as well, who will assess your fitness for the procedure. You may have to stop any blood thinning drugs, such as Ecosprin / Clopidogrel at least 4-7 days prior to the surgery, in consultation with your physician/ cardiologist.
You will be required to get admitted one day prior to surgery, with overnight fasting (NO FOOD, NO LIQUIDS, NO WATER—ANY EARLY MORNING MEDICINES TO BE TAKEN WILL BE INFORMED BY YOUR ASSESSING PHYSICIAN). At the time of admission, the attending nurse will then fill out a nursing form, make sure all your belongings are taken care of , ensure that you have changed into a hospital outfit and give you general instructions. Our surgical registrar and the anaesthetist will be seeing you as well, to answer any last minute queries and to take a well informed consent from you and a relative/ witness.
On the day of surgery, you will then be shifted to the operative suite. In the operation theatre, you will undergo the procedure which roughly lasts for 2- 2 ½ hours or so. Sometimes it may take a little more time, which is no cause for concern. After the procedure is over, you will be shifted to the recovery suite and then to your room, once you are completely conscious, pain- free and comfortable.
You will notice a large tight dressing over the operated side, with 2 plastic bottles by your side. The tight dressing is given to prevent bleeding at the operated site. You will be encouraged to sit up, take fluids orally after 6 hours. Generally, by evening or night-time (if you have been operated in the first half of the day) you will be having your normal diet. You may go to the washroom with an attendant by your side.
POST –OPERATIVE PERIOD:
1st post-operative day:
You will receive a sponge bath, or may be allowed to have a bath after the nurse applies a plastic dressing over your existing dressing to avoid getting it wet. You need to take adequate precautions to avoid wetting the dressing. If it does get wet though, please inform the surgical registrar; the dressing may then need to be changed.
You can have your normal diet and we advise plenty of oral fluids to prevent constipation. You can move around, take a walk as you please and as frequently as you wish. We will provide a bag to keep the drain bottles in, to avoid them getting pulled off. Please ensure that the bag is slung over your shoulders when you move around.
We normally stop giving intravenous fluids, injections by the first post-operative day. Painkillers are given as required. Exercises will be taught to you, primarily to keep your operative site arm well mobilised. You are advised to continue these exercises daily.
Generally, we advise a stay of 3-4 days after surgery. We change the dressing on the 3rd or 4th post- operative day and discharge you (send you home) thereafter. At the time of your discharge, we provide you with a discharge summary, which provides details of your treatment in the hospital and the medicines to be taken at home. You will be advised to follow up on a specific date and time for a check dressing.
These bottles are part of a closed suction mechanism that is applied to the wound, to prevent collection of any fluid inside the wound and to ensure that it is drained out completely. The fluid is initially reddish, which then becomes clear later on. The amount of fluid drained has no bearing on the severity of the disease or on the recovery. The drains are kept in place as long as the fluid keeps draining.
We maintain a daily drain output chart, which tells us how much fluid is being drained every day. Once the drain amount decreases to a satisfactory level, we will remove the drains. You will be discharged with the drains and asked to keep an account of the daily drain output.
In case of pain, fever or redness at the operated site, please contact us and see us at the earliest.
Your pathology report will be ready after 8-10 days, which you require to collect at the report counter and bring with you at the time of consultation. Further treatment is based on the pathology report. However, in general, no further treatment is started until 3 weeks after surgery.