Whenever there is a break in the integrity of the nipple skin, the
nipple should be washed in warm water and mild soap 2-3 times a day to
prevent ascending infection.

I have found glycerin gels (soothies) to be helpful for full thickness
wounds like you describe.  They prevent scabbing, and allow moist wound
healing to occur.  Perhaps an amorphous hydrogel (which comes in a tube
and is squeezed onto the wound and covered with a breathable dressing)
would be more useful for this severe a wound, but I have no experience
using this form of dressing on nipples.  Since the baby will not be
breastfeeding for a few days while mom heals, ingestion should not be an
issue.

My dad had a very severe surgical wound  from decompression of
compartment syndrome in his leg after vein harvesting for cardiac
bypass.  He was expected to need skin grafts and multiple surgeries to
close it.  6 months of moist wound healing including the use of
amorphous hydrogel allowed it to heal without surgery and with minimal
scarring.   I was already sold on moist wound healing, having used it
with clients for several years, but this really made a believer out of me.


--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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