Nonselective debridement and antimicrobial cleansing of a venting ductal breast carcinoma.

Abstract

A woman with a moderately differentiated carcinoma that erupted through the skin and amputated her breast was treated with whirlpool, topical antimicrobials, radiation, and chemotherapy. The draining, necrotic, and septic wound was treated for 5 months with a whirlpool containing dilute povidone-iodine solution and intravenous chemotherapy. Wet bandages, necrotic tissue, and softened eschar were removed by whirlpool agitation or mechanically debrided. To start treatment the wound was dressed with Debrisan crystals and sterile gauze for 1 week. Afterwards, wet-to-dry dressings wetted with Dakin's solution were applied. Tissue ingrowth at the wound margin started after 2 weeks, with whirlpool treatments effecting a tissue-reddening hyperemia. Wound drainage ceased after 2 months, with granulation and revascularization resulting. Eleven months later the wound was closed, aseptic, and undergoing dry flaking. The patient was cancer free with a completely healed wound 2 years after treatment. In this case, nonspecific debridement using whirlpool and topical antimicrobials promoted healing of an open fungating wound from a breast carcinoma.