Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report

TL;DR

A 64-year-old woman with a history of breast cancer and radiation therapy developed a wound after mastectomy, which healed using a synthetic fiber matrix without further surgery.

Contribution

First reported use of a synthetic electrospun fiber matrix to heal a dehisced wound in a previously irradiated area without invasive intervention.

Findings

The synthetic electrospun fiber matrix successfully healed the dehisced mastectomy wound.

The treatment avoided the need for further invasive surgical intervention.

This case highlights a potential new option for managing irradiated wound complications.

Abstract

Breast-conserving surgery (BCS) is a well-established standard treatment option alternative to mastectomy for patients with early breast cancer that consists of a lumpectomy followed by adjuvant radiotherapy. However, irradiated tissues are at an increased risk of wound healing complications when post-treatment surgical management is required. The management of an irradiated wound dehiscence can be challenging, as it often requires a multimodal treatment approach that includes more invasive interventions when compared to a traditional surgical wound dehiscence. We present a 64 year old female patient with a remote history of right BCS with radiation therapy for early breast cancer 12 years ago, who recently required a simple mastectomy due to ipsilateral breast cancer recurrence. The post-operative course was complicated by dehiscence of the mastectomy wound. After standard wound care therapies failed, her surgical wound successfully healed after treatment with a synthetic electrospun fiber matrix application. Patients with additional comorbidities often do not qualify for invasive reconstructive options; therefore, effective local management options are warranted. This is the first reported case documenting synthetic electrospun fiber matrix efficacy and safety in healing a dehisced surgical wound within a previously irradiated fibrotic area, without the need for further invasive surgical intervention. Larger scale research, such as a prospective cohort study or randomized control trial, is needed to investigate its novel use in irradiated wounds.

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