This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: On July 23, 2015, I had a mastectomy with reconstruction (DIEP flap) on my right breast. After several weeks, eschar (sp) had to be removed and under one area was a pocket of fluid (seroma). A hole was left and it is packed with gauze twice a day by my home health company. Just yesterday the fluids on the packing etc. were discolored…it appears to be a bluish color mixed in with watery blood. Is that a sign of infection? And why does it appear to be blue?

Answer: Thank you for your question! I’m sorry you are having wound problems. You should definitely ask your surgeons that question. I don’t know of any infections associated with blue colored fluid. Another possibility would be related to your mastectomy. If you had a nipple sparing mastectomy and the nipple skin developed an eschar, I’m sorry to hear that.  Sometimes the nipple is injected during surgery with a blue dye. This dye helps the breast surgeon find your sentinel lymph node. I am not sure how long that blue dye would stay in a pocket of fluid. You should definitely ask your breast surgeon about the blue dye. Many eschar wound healing problems heal just fine in the long run. I tell my patients that, if the scar is bad, we may need to revise it later. As long as the new breast has a healthy blood supply there is a lot that can be done to improve wound healing problems. Please let me know if you have other questions.

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