What is seroma and how is it treated? Isolation of serous fluid from under the postoperative suture

After surgery, in some cases, a complication such as seroma occurs. So what is it? This is the accumulation of serous fluid in the area of ​​​​the surgical wound. Especially often seroma occurs in obese people. With the development of such a disease, an odorless straw-colored serous fluid begins to drain from the wound, the disease is accompanied by severe swelling, and in some cases, painful sensations.

Often seroma occurs after a variety of plastic surgeries. In many cases, it can resolve on its own in about two weeks. At the same time, a large amount of seroma leads to stretching of the skin, as a result of which it begins to sag ugly. All this causes great anxiety and discomfort in the patient. This complication leads to an increase in the recovery period and regular visits to the doctor. The photo clearly shows what a seroma looks like.

Causes

With this disease, there is usually no pain. Only sometimes they can appear, but only if the volume of serous fluid is very large. Therefore, it is almost impossible to immediately recognize the presence of a seroma.

Most often seroma occurs as a result of damage to a large number of lymphatic capillaries, which are not able to thrombose as quickly as blood vessels. This leads to the accumulation of serous fluid. Due to the presence of blood, the seroma acquires a reddish color.

Other reasons for this complication:

• Traumatic work with tissues.

Seroma postoperative

With soft tissues, the surgeon must work very carefully. He should not grab them roughly and use tools that can compress the tissue. The cuts must be made very carefully, in one motion. Numerous incisions increase the area of ​​damaged tissues several times which contributes to the formation of seroma.

• Excessive use of coagulation.

It is used if tissue burns occur. Any burn causes necrosis, accompanied by the formation of an inflammatory fluid (exudate). Coagulation should only be used in isolation to cauterize a bleeding vessel.

• Large thickness of subcutaneous adipose tissue.

It should be no more than 5 cm, otherwise, seroma is almost always formed. Therefore, if the thickness of the subcutaneous adipose tissue is exceeded by more than 5 cm, liposuction must first be performed. Three months after that, you can do an abdominoplasty.

Also, the causes of seroma are: old age, high blood pressure, diabetes.

Seroma symptoms

A seroma may be suspected if the following symptoms are present:

If serous fluid reached large volumes then the following symptoms occur:

• Soreness or a feeling of tension in the area where the seroma has accumulated. Most often it is the lower abdomen.
• Drawing pains that begin to intensify if the patient gets to his feet.
• Redness of the skin in the place where the seroma has accumulated the most.
• General weakness, fever up to 37 degrees, fatigue.

Seroma treatment

This disease is treated in two ways:

• surgical method;
• medical method.

In the surgical method of treatment, a puncture is used. This is the most common method used to remove fluid. In 90% of cases, this brings a positive result. Using a syringe, the surgeon removes serous fluid, the volume of which can reach 500-600 ml. Gray should be pumped out constantly every 2-3 days. To completely get rid of it, make from 3 to 7 punctures. In especially severe cases, more than 15 punctures may be required. After such manipulations, the amount of serous fluid decreases.

In patients with a large thickness of subcutaneous adipose tissue, the seroma is large and therefore puncture is usually not enough. That's why it is necessary to install a drain with active aspiration. The fluid through the drainage begins to constantly drain, decreasing in volume, and after a while the cavity closes, grows together and the seroma disappears.

Medical method of treatment consists in the use of:

• broad-spectrum antibiotics;
• non-steroidal anti-inflammatory drugs, which are used to relieve aseptic inflammation and reduce the amount of fluid;
• sometimes steroidal anti-inflammatory drugs such as kenagol and diprospan are prescribed, which relieve inflammation well and reduce the amount of fluid.

Prevention of seroma formation

Preventive measures are based on the following surgical principles:

Thus, seroma is a rather unpleasant complication and it is by no means impossible to ignore it. By itself, such a disease will not go away. and it needs to be treated. Only timely competent treatment can guarantee a wonderful result and a complete recovery.

Hello, 18 days ago I had an abdominal operation to remove the gallbladder with one large stone. The seam, it seems, heals well, does not hurt, but the temperature rises to 37.4 in the evening. After the operation, it did not subside at all, it was always in the range of 37.4-37.8, now it is 36.8 in the morning. But the question is not this, but the fact that two days ago I woke up in the morning all wet in the area of ​​\u200b\u200bthe seam, a small hole formed on the seam from which a yellow liquid flows out, odorless, very similar to thick yellow chicken broth, for a day this liquid stood out, where 500 gamma ran out in a day, and then it seemed that the hole began to tighten, but last night it reappeared and this liquid flowed again, at night it was all wet again, what could it be, I’ll get to the surgeon only after 2 days. What is it all about? Thanks in advance for your reply

Tatyana, Kokshetau

ANSWERED: 10/09/2016

Hello, thank you for your question and detailed description. This is a seroma after a surgical suture. It's not scary. Subcutaneous fatty tissue heals somewhat longer than the skin itself. Somewhere in the subcutaneous fat layer, the serous fluid did not accumulate and now found an outflow.

Clarifying question 11.01.2017 Natalia Nikitina, Tula

Hello. On November 22, there was an operation band. Peretonitis, the small intestine was brought out (ileustoma), then the stoma began to leave and a funnel formed and it was impossible to glue the colostomy bag, they escaped as best they could. More than a liter flowed out of the stoma in a day, everything around was burned. We went for a consultation with a doctor (as recommended) to an oncologist and I was left in the hospital. A decision was made to reconstruct the stoma. The second operation was carried out on 11 December. And now the sutures were removed and the sutures parted in two places, holes formed and a slightly viscous yellowish liquid flows, what should I do? I have diabetes.

ANSWERED: 01/12/2017

Hello, thank you for the detailed description, do nothing, you clearly described everything that has already happened, now you will definitely have an observation by the operating surgeon, it’s better than him to have a nickname about you, or rather, he doesn’t know about your stomach.

Similar questions:

Postponing surgery is only half the path to a healthy life. Quite often, the most difficult period is the postoperative period, which is not only painful, but also carries a considerable risk of complications. Quite often, edema occurs at the suture site with a detachable yellowish liquid. This phenomenon is called a seroma.

Causes of seroma

The most common seroma occurs after abdominal surgery. With surgical intervention in the abdominal wall, there is a risk of complications with a large size of the abdomen, since excess weight creates an additional load on injured tissues. Under the weight of the fat layer, the skin is pulled back, the junctions of the tissue are displaced, as a result of which the seam not only does not grow together, but new foci of injured blood and lymphatic vessels appear. The accumulation of protruding blood and lymph at the site of microtraumas directly leads to the formation of a pathogenic environment in the suture area.

When performing mammoplasty, there is also a high risk of serous fluid formation due to implant rejection and the occurrence of an inflammatory process.

To the most common factors contributing to the occurrence of complications include:

• elderly age;
• diabetes;
• excess weight;
• hypertension.

An important factor accompanying the appearance of seroma is the incorrect behavior of the doctor during the operation. During surgery, trauma to venous and lymphatic capillaries inevitably occurs, so the surgeon must handle soft tissues very delicately, without pinching them or injuring them with instruments. The tissue incision must be made in one confident movement.

It is necessary to use coagulation only in necessary cases, aiming at the bleeding vessel, trying to cauterize the minimum amount of tissue, because as a result of such manipulations, a burn occurs, and it, in turn, causes necrosis. The occurrence of necrosis is almost always accompanied by the formation of an inflammatory fluid.

The threat of seroma is also too large a layer of adipose tissue at the site of the operation. In order to avoid complications, it is necessary to preliminarily carry out liposuction so that this layer does not exceed 5 cm in thickness.

The main signs of the disease

The main symptom of seroma formation is swelling of the surgical site. Sometimes swelling causes aching pain and a feeling of fullness. Palpation can also be accompanied by painful sensations. Possible fever, general malaise.

In advanced cases, a serous fistula may occur - an opening through which serous fluid is separated. A fistula occurs in thinned tissues, usually along the seam, increasing the risk of blood poisoning. In such situations, repeated surgery is necessary.

Seroma Treatment Methods

For the treatment of seroma resort to one of two methods:

• medication;
• surgical.

For medical treatment, prescribe:

• antibiotics;
• non-steroidal anti-inflammatory drugs;
• steroidal anti-inflammatory drugs;
• physiotherapy.

In the absence of a positive effect from drug treatment or with especially neglected serous inflammation, they resort to surgical intervention. Most common treatment for seroma is the puncture. This procedure is performed until all the serous fluid is removed and the tissues are fused. The frequency of this procedure is 2-3 days. In total, from 7 to 15 punctures can be performed.

In the presence of a thick layer of adipose tissue, drainage is used, which is installed in the affected area, and serous fluid is separated through it.

Prevention measures

The best prevention of seroma formation is a well-performed operation, the main rules of which are: careful handling of tissues by the surgeon, point coagulation, high-quality postoperative suture with minimal gaps.

On the part of the patient, the necessary measures are the proper hygiene of the seam, which involves its self-treatment with antiseptics. After surgery, doctors strongly recommend that patients wear compression garments or bandages that securely fix the postoperative suture, as well as choose clothes made from breathable materials. In the first weeks after the operation, it is also necessary to observe physical rest, since excessive motor activity contributes to the displacement of the operated tissues, as a result of which the fusion of the suture is delayed and complicated by inflammation.

A seroma is one of the types of complications after surgery, it appears in the form of an accumulation of seroma fluid in the area where the surgeon intervenes. The most common cause is damage to the lymph node during surgery. For any surgeon, the detection of a seroma is a serious problem that requires immediate treatment; if the seroma fluid is allowed to accumulate for a certain time, complications that are irreversible for the patient may occur.

If signs of seroma are detected independently after surgery, you must immediately inform the operating doctor about this, indicating the exact time and day of detection of signs.

The main symptoms of seroma postoperative scar and the appearance of seroma fluid in the mammary gland.

As a rule, seroma appears quickly after surgical procedures, its permanent features should be noted:

1. feeling of tightness in the wound area, severe pain;
2. feeling of heaviness and volume at the site of surgery;
3. rapid rise in body temperature;
4. swelling of the operation site, tissue edema;
5. seroma occurs with obvious redness on the skin.

Seroma that has arisen in the mammary gland has the following features:

1. a clear change in shape and increase in size in the affected gray breast;
2. noticeable severe swelling;
3. pain is constant, does not depend on touch or movement;
4. serous fluid protrudes after pressing on the scar;
5. bright redness in the area of ​​the scar.

There is no need to try to independently diagnose the presence or absence of seroma, if there are clear signs of the onset of the disease, immediately consult a surgeon.

Treatment options for seroma using various agents

1. Drainage of the wound and accumulation of seroma fluid. The first thing to achieve with this action is to remove all the accumulated lymph through the drainage tubes; if necessary, the tubes must be placed in different places for uniform stripping along the entire scar.

2. Pulling out the seroma fluid with dissection of the scar. The method is applied at the early stages of the formation of the disease, carried out with the help of an apparatus that creates vacuum pressure.

3. To enhance the effect of the first two treatment options, it is recommended to drink anti-inflammatory decoctions (for example, a strong decoction of chamomile, tea with thyme). This method only helps to enhance the effect of treatment, does not replace it.

Prevention of the development of seroma and accumulation of lymph at the sites of surgical incisions

To most effectively reduce the possibility of seroma after surgery, you need to follow a few recommendations:

1. after operations, especially with abdominal dissection of the skin, the patient is strictly forbidden to expose himself to physical exertion;
2. daily dressings with disinfection of the wound and the area near the seam;
3. it is strongly recommended to use a bandage or tight underwear for 3 months after the operation so that the area of ​​​​the seam is compressed, the use of elastic bandages is allowed;
4. strictly follow the diet, try not to overeat and diversify food as much as possible, which will contribute to healing;
5. avoid alcohol and give up sweets.

Summing up, it should be understood that not every operation leads to the formation of a seroma, but if you find signs of the accumulation of seroma fluid, do not hesitate, immediately inform the surgeon. On your own, according to rumors and advice, you should not try to treat gray matter, this is a complex disease that can lead to serious complications in a short time.

A seroma is a collection of fluid under the skin. It is formed most often as a side effect of surgical exposure. The accumulation of serous fluid in some cases is also an incorrect or incomplete rehabilitation.

What is a seroma

A seroma is a collection of serous fluid at the intersection of capillaries. The accumulation of lymph usually occurs within the cavity, which is within the fatty tissue and aponeurosis of the human skin. That is why this symptom is the most common complication after surgery in overweight people.

The fluid accumulated in the cavity is an ideal habitat for pathogens. Therefore, with such a manifestation, it is necessary to eliminate the symptom. If you do not engage in adequate therapy in accordance with the patient's condition, then the risk of developing an infectious disease increases significantly.

Serous accumulation is generally a fairly common occurrence, which is easily eliminated by preventive measures in the form of drainage, weights in the area of ​​the seams, as well as compression underwear. With this exposure, the symptom usually resolves on its own and without complications. If you do not take therapeutic methods of exposure, then there is a risk of developing necrosis of the skin flap,.

It is also worth considering that due to seroma, the healing time of the sutures increases, and therefore the doctor will have to visit longer than originally planned.

The opening of the seroma of the postoperative scar of the lower leg after phlebectomy is shown in the video below:

Reasons for the appearance

There is a whole list of factors that affect the development of seroma after intervention in the body from the outside:

• Lymph capillaries;
• Inflammatory processes in the suture area;
• Overweight;
• Elderly age;
• Large volumes of the operation, in which a larger number of lymphatic connections are damaged;
• Individual reaction of the body to the intervention;
• Excessive tissue injury during the procedure;
• Squeezing of tissues during the operation;
• after operation;
• Excessive abuse of tissue coagulation;
• Lack of drainage;
• The reaction of the body to the suture material;
• Incorrect recovery period.

Accordingly, we can conclude that the formation of a seroma requires the intervention of a surgeon, and the greater this effect, the greater the seroma will be in the future. Most often develops after a mastectomy, (including),.

Seroma after mammoplasty (photo)

How to get rid of them

Getting rid of seromas is most often offered with the help of surgical or minimally invasive intervention, which depends on the stage of the pathology. There are also medication ways to stop and prevent the development of a symptom. The sooner the visit to the doctor occurs, the more optimistic the forecasts for therapy are.

At home

At home, you must do the following:

• With an unlaunched seroma, a strong infusion of thyme or chamomile, or herbs that also have an anti-inflammatory effect, is brewed.
• If this complication has developed on the lower extremities, then you should put your foot on several pillows so that blood circulation in the tissues goes from bottom to top. Thus, puffiness is eliminated.
• Wearing tight compression underwear or wide elastic bandages.
• Imposition of a load weighing no more than 1 kg on the operating area. It can be a bag of salt or sand.

As a rule, compression underwear itself promotes the resorption of serous fluid in the cavity, exerting the necessary degree of pressure on the inflamed area.

It should also be understood that it is impossible to warm up the area of ​​​​impact, as this will only increase the chances of tissue infection.

Troubleshooting is shown in this video:

Care

Speaking about care, it should be understood that the intervention area can only be treated with antiseptics on its own, such as:

• Zelenki;
• Alcohol infusion;
• Yoda;
• Hydrogen peroxide;

Any means to choose from the list is taken and processed. After that, an antibacterial ointment is applied, if the situation requires it, and only then a sterile dressing.

Preparations

The following types of drugs are used for seroma:

• Broad spectrum antibiotics: Abaktal,