What is a Seroma?
Seroma is a condition in which fluid seeping out from the damaged blood vessels accumulates in tissue spaces created by a surgical procedure or else following trauma to a susceptible area. The condition is the commonest post operative complication following mastectomy procedures and it can manifest in other surgical procedures such as abdominoplasty, lymph node removal and lumpectomy as well. Although the condition is not as serious as the development of a hematoma, which is the accumulation of blood, it can become a nuisance for the patient as well as for the clinicians as repeated fluid aspirats and evacuates may be needed before a seroma disappears once and for all.
What leads to the formation of a seroma?
As mentioned earlier, the seroma refers to the accumulated serous fluid and its origin would most likely to be the tiny blood vessels which becomes damaged due to surgery or trauma. Although the serous fluid can leak into the tissue planes, the blood cells cannot creep through and therefore the outcome would be a seroma rather than a hematoma.
It should be remembered that, the underlying problem in places such as the breast, abdomen and at sites of lymph nodes would be the dead space and at times the heavy vascularity. Because of the time it takes for these damaged blood vessels to repair themselves and the less likelihood for the surgeon to be able to tie these tiny blood vessels would make these sites considerably vulnerable to the formation of a seroma.
How can a seroma be prevented from taking place?
When a surgeon performs surgeries which are prone to give rise to seromas, they will take every measure in the book to prevent it from happening although it is rather difficult to prevent this complication. Among the techniques used, insertion of a drain should be considered the main strategy which is effective in many instances. Apart from this, newer techniques in reducing the dead space created such as tucking-in a muscle flap during radical mastectomy could also be highlighted.
Following surgery, a tight bandage will be applied to the surgical site and it is expected to be in place for several days before it is removed. At the same time, resting the surgical site to prevent the wound from becoming stretched can also help reduce the fluid collection and therefore the formation of a seroma.
When a mastectomy or lumpectomy is performed, the patients are advised to wear a tight bra to exert pressure over the surgical site to make the tissue oppose and therefore leave less likelihood of fluid leak and to increase wound healing.
Preventing a possible infection at the site of the surgery is another method to avoid formation of a seroma and feeling for warmth, redness, and excessive tenderness after few days from the surgery could indicate a possible infection at the site. Furthermore, the wound should be kept clean as introducing infective agents may be detrimental to the health of the wound.
Lastly, it should be remembered that, mild buildup of fluid at the surgical site may be allowed in modern day surgery and in most instances, these will settle itself and would not lead to the development of a seroma.