Transrectus Abdominal Muscle Flap (TRAM) Breast Reconstruction

Care After

These discharge instructions provide you with general information on caring for yourself after you leave the hospital. While your treatment has been planned according to the most current medical practices available, unavoidable complications occasionally occur. It is important that you know the warning signs of complications so that you can seek treatment. Please read the instructions outlined below and refer to this sheet in the next few weeks. Your caregiver may also give you specific information. If you have any complications or questions after discharge, please call your doctor.

ACTIVITY

  • You should rest as much as necessary your first two weeks at home.

  • Take walks once or twice per day, weather permitting. Increase lengths of walks as tolerated. Your doctor or physical therapist will advise you when you may resume strenuous activities, driving and sports.

  • After the drain(s) are removed, you may do light housework, but avoid heavy lifting (nor more than 10 pounds), carrying or pushing.

  • Take frequent rest periods throughout the day. You may tire more easily than usual. No strenuous activity for 6 weeks.

NUTRITION

  • You may resume your normal diet.

  • Make sure you drink plenty of fluids (6-8 glasses a day).

  • Eat a well-balanced diet. Daily portions of food from the meat (protein), milk, fruit, vegetable and bread families are necessary for your health.

ELIMINATION

  • You should return to your usual bowel function.

  • You may experience constipation due to pain medication and decreased activity level. You may take a mild laxative, such as Milk of Magnesia, Metamucil, or a stool softener, such as, Colace.

HYGIENE

  • You may wash your hair.

  • If your incision is closed, you may shower 24 hours after your drains are removed.

  • Do not tub bathe for 4 weeks.

  • Your breast reconstruction has decreased your sensation; always test the water temperature before you stand in the shower or enter the tub.

FEVER

  • If you feel feverish or have shaking chills, take your temperature. If your temperature is 102° F (38.9° C) or above, call your doctor. The fever may mean there is an infection.

  • If you call early, infection can be treated with antibiotics and hospitalization may be avoided.

PAIN CONTROL

  • Mild discomfort may occur. You may need to take an "over-the-counter" pain medication or a medication prescribed by your caregiver.

  • Call your doctor if you experience increased pain.

INCISION CARE

  • A dressing is not needed unless the cut from surgery (incision) is draining or irritated.

  • Check your incision daily for increased redness, drainage, swelling or separation of skin. Call you doctor if any of the above are noted.

ARM AND HAND CARE

If you had an removal of lymph nodes under the arm (axillary node dissection) you will need to follow specific instructions for arm and hand care. Since the lymph nodes under your arm have been removed, there may be a greater chance for the arm to swell. The chance of swelling is also increased by infection.

The following instructions may help reduce the risk of arm swelling:

  • Avoid, if possible, having blood pressures taken, blood drawn or injections given in the affected arm.

  • Use hand lotion to soften fingernail cuticles instead of cutting them to avoid cutting yourself.

  • Be careful when shaving your underarms. Use an electric shaver if possible. You may use a deodorant after the incision has completely healed, but until then, clean under your arms with hydrogen peroxide or soap and water.

  • Use reasonable precautions when cooking, sewing and gardening to avoid burning, needle or thorn pricks.

  • Do not weigh your arm straight down with a package or your purse.

  • If your caregiver wants you to do arm exercises after surgery, a physical therapist/occupational therapist will be ordered to see you and instruct you. Your doctor may prefer that you wait to exercise your arm.