Seroma - causes, symptoms, treatment and prevention
Seroma is a collection of fluids leaking out from the damaged capillaries and lymphatic vessels following a surgery or a traumatic injury. It usually is filled with a clear fluid while presence of cells is not unusual. While many small seromas subside by itself, some may require further interventions while in rare instances, seromas can also lead to wound related complications such as infections, delayed healing and wound dehiscence. However, if managed carefully, seromas can be cured completely within few days of its formation or even prevent such cysts from occurring in the first place.
Causes of seroma
The reason for the formation of a seroma is the accumulation of fluids leaked out from the damaged capillaries and lymphatic vessels. Thus, the amount of tissue damage is a direct cause of its formation. Therefore, surgeries such as removal of breast due to breast cancer, hernial repairs, breast augmentation, breast reduction and certain other plastic surgeries could give rise to seroma formation as it involved extensive tissue manipulation. However, in some instances, there could be a seroma formation even without such extensive tissue damage although such manifestations are relatively rare.
Symptoms of seroma
In general, a seroma could manifest soon after a surgery unless proper drainage mechanisms have not been adapted by the surgeon. However, in some instances, the formation of the seroma may take place even in the presence of a drainage. Meanwhile, it is also possible for a seroma to form once the drainage has been removed. In all these instances, the presence of a swelling on or near the surgical or wound site could be the first indication of a seroma and in certain instances, the lump may only be noticeable when one does a deep palpation.
Fluid leakage is another symptom that may manifest among people who develop seromas and this usually appears as a clear fluid as against the thick and yellowish discharge seen during an infection.
Usually, a seroma does not give rise to a pain apart from a mild discomfort, most probably with the movements. However, when the seroma is infected, the pain may obvious and in such instances, it will also be associated with a discharge of pus, opening of a wound, reddening of the surgical site and even a increased tenderness over and around the surgical site.
Treatment of a seroma
The main cause of action for large seromas is to aspirate the fluid content and in some instances, one may need multiple aspirations until the fluid accumulation subside. Insertion of a draining tube attached to a vacuum device is the preferred choice in many instances of extensive surgeries and in such instances, the draining fluid will be monitored daily in order to find out if the volume of accumulated fluid has gone down to reasonable levels. Once it reaches a minimum amount, the doctors would decide on removing the draining tube as the body itself is able to absorb the small amount of leakage that may take place after removing the draining tube.
In the event of an infected seroma, one may need to take intravenous antibiotics as oral antibiotics may not be adequate in order to settle an infected wound. In such instances, the patient may also have to be given pain relievers and anti-inflammatory agents in order to reduce the swelling as well as to ease the discomfort.
Prevention of seroma
As mentioned earlier, the best method of preventing a seroma formation is to insert a draining tube, during the surgery to expel the accumulated fluids, when extensive tissues damages have taken place. Application of a tight dressing and asking the patient to wear a tight bra with padding in the case of breast related surgeries have also contributed to lessening the incidence of seroma formation. Avoiding unnecessary movements which can aggravate the tissue damages could also help in minimizing the potential for fluid collection.
Apart from the post-surgical measures, surgeons will also have to take necessary precautions to avoid the formation of seromas although in some instances, however much they do, the inevitable may take place.