bruises and bleeding after Mastectomy

[Oceanlover]

Dear Doctors, I had a preventive mastectomy on Sept. 20th. I found immediately that I had a lot of bruises around the wounds and on my wrist. One week later, the date when I suppose to have the drain moved, my surgeon told me that the blood was not drained well, but she did not want to open it. She tried to drain it with niddles, but did not work well. She keeps the drain on me and I went to see her again on Oct. 3rd. up to this time, I got about 25ml drain of blood everyday. My surgeon told me not to worry, since the wound did not look worse and the blood was "old blood". I went to see her again on Oct. 6th, and the same story as above. She asked me to go back and see her again on Oct. 12th.

Now, I still have the drain on me (18 days after my surgery), everyday, there is about 25ml drain of dark color blood. I have more bruises now between my leg and stomach.

Would you please let me know how come I have so much "old blood" coming out everyday and why I have so many bruises and I feel ache many places between my shoulder and thigh on the side of my surgery. Shall I worry about these signs? (by the way, I had Mastectomy on the other side two years ago and had chemos and radiations during that time).

I really appreciate your help. Have a wonderful day!

[CCF-RN,MSN-rf]

Dear oceanlover:  Sometimes, there is bleeding into the tissue after surgery that can form a hematoma (collection of blood under the skin) if there were no drain.  Since there is a drain, the blood can escape.  In most cases, this will eventually run its course and the drain can be removed.  You may benefit from a discussion with your doctor regarding the other bruising and aches and pains.

[surgeon]

It's not rare to have some bleeding right after surgery; when it happens, it may not all get out the drains, especially if it forms clots under the skin away from the drains. Then the blood stays there for a while. As it slowly liquefies, it can drain; so what happens is you keep getting drainage of "old" blood, meaning blood from bleeding which occurred right after surgery, but which doesn't indicate any active bleeding going on. Some of the blood makes it to the surface and causes bruising of the skin. By gravity, some of that will appear well below where the surgery was.That sort of thing happens frequently after mastectomy, and indeed is usually not something to worry about. Rarely some of the accumulated blood can become infected before it dissipates. But usually not.