What to do if clear liquid, lymph, or ichor flows from the wound. Discharge of serous fluid from under the postoperative suture Serous fluid causes

Having 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, swelling with yellowish fluid discharge occurs at the suture site. This phenomenon is called seroma.

Causes of seroma

Seroma most often occurs after abdominal surgery. When undergoing surgery in the abdominal wall, there is a risk of complications with a large abdomen, since excess weight creates additional stress on the injured tissues. Under the weight of the fat layer, the skin is pulled back, the tissue junctions are displaced, as a result of which the seam not only fails to heal, but also new foci of injured blood and lymphatic vessels appear. The accumulation of protruding blood and lymph at the site of microtrauma directly leads to the formation of a pathogenic environment in the suture area.

When performing mammoplasty, there is also a high risk of the formation of serous fluid 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, injury to the 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 cut must be made in one confident movement.

Coagulation should be used only in necessary cases, targeting the bleeding vessel, trying to cauterize a minimum amount of tissue, because as a result of such manipulations a burn occurs, and this, in turn, causes necrosis. The occurrence of necrosis is almost always accompanied by the formation of inflammatory fluid.

The risk of seroma is also caused by too much fatty tissue at the surgical site. To avoid complications, it is necessary to perform liposuction first so that this layer does not exceed 5 cm in thickness.

Main signs of the disease

The main sign of seroma formation is swelling of the surgical site. Sometimes swelling causes aching pain and a feeling of fullness. Palpation may also be accompanied by painful sensations. Possible fever and 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 a suture, increasing the risk of blood poisoning. In such situations, repeated surgery is necessary.

Treatment methods for seroma

To treat seroma, one of two methods is used:

medicinal;
surgical.

For drug treatment the following is prescribed:

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

In the absence of a positive effect from drug treatment or in case of particularly advanced serous inflammation, surgical intervention is resorted to. Most common treatment for seroma is to perform a puncture. This procedure is performed until all serous fluid is removed and the tissues have healed. The frequency of this procedure is 2-3 days. In total, from 7 to 15 punctures can be performed.

If there is a thick layer of adipose tissue, a 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 competently performed operation, the main rules of which are: careful handling of tissue by the surgeon, targeted coagulation, high-quality postoperative suture with minimal gaps.

The necessary measures on the part of the patient include proper hygiene of the suture, which involves treating it independently with antiseptics. After surgery, doctors strongly recommend that patients wear compression garments or bandages that securely fix the postoperative suture, and also choose clothing made from breathable materials. In the first weeks after surgery, it is also necessary to maintain physical rest, since excessive physical 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.

Serous fluid is not the biggest postoperative problem, but some complications can still arise that cause discomfort to the person. Fluid accumulation occurs at the intersection of capillaries. That is, lymph accumulates within the cavity, which is located near the aponeurosis and fatty tissue under the human skin.

That is why such complications most often occur in dense people with a large layer of fat under the skin. During the development of a disease associated with serous fluid, a straw-colored discharge may appear, which does not have an unpleasant odor, but severe swelling may appear, and sometimes a person even feels pain at the site of seroma accumulation.

Most often, the accumulation of serous fluid occurs precisely after surgery. For example, we can distinguish plastic surgeries, after which fluid accumulates, which leads to negative consequences. These side effects do not affect human health in any way, but undesirable phenomena such as sagging skin in places where fluid accumulates may still appear, which of course spoils the aesthetic appearance of a person. In addition, seroma increases the healing time of the skin, and because of this you have to visit the doctor more often, which also causes inconvenience.

At-risk groups

Theoretically, seroma can occur after any violation of the integrity of lymph vessels, which do not “know how” to thrombose quickly, as blood vessels do. While they are healing, lymph continues to move through them for some time, flowing from the rupture sites into the resulting cavity. According to the ICD 10 classification system, seroma of the postoperative suture does not have a separate code. It is assigned depending on the type of operation performed and the reason that influenced the development of this complication.

In practice, it most often occurs after such cardinal surgical interventions:

abdominal plastic surgery;
cesarean section (this postoperative suture seroma has ICD 10 code “O 86.0”, which means suppuration of the postoperative wound and/or infiltration in its area);
mastectomy.

As you can see, it is mainly women who are at risk, and those who have solid subcutaneous fat deposits. Why is that? Because these deposits, when their integral structure is damaged, tend to peel off from the muscle layer. As a result, subcutaneous cavities are formed, in which fluid begins to collect from the lymph vessels torn during the operation.

The following patients are also at risk:

those suffering from diabetes;
elderly people (especially overweight);
hypertensive patients.

Causes of seroma

The accumulation of serous fluid in the area where the surgical suture is located is caused by the presence of a wide variety of factors that took place at the time of surgery.

The main causes of seroma development are:

Excessive activity of lymphatic capillaries. Even an operation that does not pose a threat to health is always local stress for the body and skin that has been injured by a mechanical incision. Under such conditions, lymphatic capillaries begin to actively synthesize lymph and redirect it to the surgical site. As a result of an abnormal reaction of the lymphatic system, the patient faces very unpleasant consequences.
Inflammatory process. Each body reacts differently to surgery. Some people's skin and soft tissues recover quickly and without complications, while there are patients who develop non-infectious inflammation of the wound surface with excessive accumulation of lymphatic fluid.
Hypertonic disease. High blood pressure can be a factor in the irrational distribution of lymph to all parts of the body.
Overweight. At least 75% of all surgical patients who are overweight face the problem of postoperative suture healing and the accumulation of serous fluid. The presence of a large amount of fatty tissue contributes to this. Patients who have elastic muscles in the abdominal area almost never encounter the problem of seroma.
Diabetes. This is a concomitant disease that is characterized by increased concentrations of glucose in the blood. Excess sugar does not allow blood vessels and the circulatory system as a whole to function normally and restore damaged tissue.
Senile age. As you age, the intensity of metabolic processes in the body decreases. The division of epidermal cells, blood, soft tissues and the formation of lymph slows down. Therefore, deviations in the recovery process and the formation of serous fluid at the incision sites are possible.

Most of these potential causes that can cause postoperative complications are identified by doctors several days before surgery. The patient takes a blood test to check blood sugar levels, coagulability, and the presence of chronic diseases of infectious origin. A comprehensive examination of the body, all its organs and systems is also carried out. Therefore, if some pathology has been established, the patient is immediately prescribed specific treatment after the operation in order to prevent the development of seroma. For example, in a patient with diabetes mellitus, during the recovery period, insulin administration is increased to the maximum limit in order to lower the level of glucose concentration in the blood as much as possible and prevent tissue necrosis around the suture, as often happens in patients with this endocrine disease.

Symptoms of seroma

Seroma can be suspected if the following symptoms are present:

The patient feels as if fluid is beginning to overflow in the lower abdomen.
Sometimes there is swelling and a feeling of bulging in the lower abdomen. Patients claim that their abdomen has suddenly increased in volume, although this was not the case a few days ago.

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 this is the lower abdomen.
Nagging pain that begins 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, increased body temperature up to 37 degrees, fatigue.

Diagnosis of seroma

Diagnosis of seroma is based on examination and instrumental research methods.

Inspection. During the examination, the surgeon will notice the presence of swelling in the lower abdomen. On palpation, fluid flows from one side to the other, a fluctuation indicating that there is an accumulation of fluid. In addition, the presence of seroma symptoms will leave no doubt for making the correct diagnosis.
Instrumental research methods - ultrasound of the soft tissues of the abdomen. With ultrasound, the accumulation of fluid between the muscles of the anterior abdominal wall and subcutaneous fat is very clearly visible. Taking into account all the symptoms and ultrasound scan results, it does not seem difficult to diagnose seroma.

Treatment of postoperative seroma

In most postoperative cases, seroma resolves within a few days. Throughout this period, the patient is observed by the surgeon and follows his recommendations for restoring the body. If fluid does accumulate and there is a risk of infection or blood infection, treatment will be needed.

Seroma is treated in two ways:

surgical,
medicinal.

Surgical method

It is considered the easiest way to remove seroma. It is carried out using a puncture. A positive result occurs in 90% of treatment.

The surgeon pumps out liquid in a volume of up to 600 ml with a syringe. The procedure is carried out regularly every 3 days. Usually the course is 3-7 punctures.

Complex serous manifestations require 15 procedures. With each subsequent procedure, the fluid decreases. If the patient has thick subcutaneous fat, tissue trauma occurs in a large volume.

With such indicators, it will not be possible to solve the problem with a puncture. You will need to install drainage with active aspiration.

Drainage will allow the fluid to drain continuously until it disappears completely. To install the drainage system, it is soaked in antiseptic.

After connection, it is fixed with additional stitches followed by regular processing. The drainage area itself is covered with a bandage and replaced daily. In this case, after natural outflow, the cavity grows together and the seroma disappears. Drainage is carried out in conjunction with drug treatment.

Drug treatment of seroma

It consists of using:

broad-spectrum antibiotics for prophylactic purposes;
non-steroidal anti-inflammatory drugs for the treatment of aseptic inflammation;
anti-inflammatory steroid drugs in rare cases. These include diprospan and kenalog to block aseptic inflammation.

Folk remedies

It is important to know that regardless of the reasons for the seroma of the postoperative suture, this complication is not treated with folk remedies. But at home, you can perform a number of actions that promote healing of the suture and prevent suppuration.

These include:

lubricating the seam with antiseptic agents that do not contain alcohol (“Fukorcin”, “Betadine”);
application of ointments (Levosin, Vulnuzan, Kontraktubeks and others);
inclusion of vitamins in the diet.

If suppuration appears in the suture area, you need to treat it with antiseptic and alcohol-containing agents, for example, iodine. In addition, in these cases, antibiotics and anti-inflammatory drugs are prescribed. In order to speed up the healing of stitches, traditional medicine recommends making compresses with an alcohol tincture of larkspur. Only the roots of this herb are suitable for its preparation. They are washed well from the soil, crushed in a meat grinder, put in a jar and filled with vodka. The tincture is ready for use after 15 days. For a compress, you need to dilute it with water 1:1 so that the skin does not get burned. There are many folk remedies for healing wounds and scars after surgery. Among them are sea buckthorn oil, rosehip oil, mumiyo, beeswax, melted with olive oil. These products should be applied to gauze and applied to the scar or seam.

Postoperative suture seroma after cesarean section

Complications in women whose obstetrics were performed by caesarean section are common. One of the reasons for this phenomenon is the mother’s body, weakened by pregnancy, which is unable to ensure rapid regeneration of damaged tissues.

In addition to seroma, a ligature fistula or keloid scar may occur, and in the worst case scenario, suppuration of the suture or sepsis. Seroma in women giving birth after a cesarean section is characterized by the fact that a small dense ball with exudate (lymph) inside appears on the suture. The reason for this is damaged blood vessels at the site of the incision. As a rule, it does not cause concern. Seroma of postoperative suture after cesarean does not require treatment. The only thing a woman can do at home is to treat the scar with rosehip or sea buckthorn oil to speed up its healing.

Seroma formation after mastectomy and abdominoplasty

As mentioned earlier, seroma can occur after plastic surgery, but the most common are mastectomy and abdominoplasty. The formation of serous fluid occurs in almost 15% of all cases of mastectomy, and this is a fairly high chance of complications. Naturally, breast surgery leads to the most common factor in the accumulation of serous fluid, namely the spread of lymph nodes and their number in this area of the body. During breast surgery, a large dissection of the skin occurs, which affects not only a large number of blood vessels, but also lymph nodes.

As a result, already at the healing stage, due to the occurrence of an inflammatory reaction, serous fluid appears under the skin. Before performing a mastectomy, doctors warn their patients about the possibility of seroma. When undergoing abdominoplasty, the chances of fluid accumulation under the skin increase even more, because here seroma appears in almost half of the cases of plastic surgery.

In fact, the reason is identical, because when cutting the skin on the abdomen, doctors touch a large number of blood vessels and lymph nodes, which, of course, lead to further inflammatory processes.

After treatment

Prevention of seroma

It is always better to prevent complications from developing.

To prevent the formation of subcutaneous fluid, it is enough to follow the recommendations of surgeons:

Immediately after the operation, a load of up to 1 kg is placed on the suture. Salt or sand can be used as cargo.
In the first three days, traditional surgical drainage is installed.
Should be taken from day one antibacterial drugs.
Don't do abdominoplasty with a thick layer of subcutaneous fat with an index of more than 5 cm. If more than 5 cm, then liposuction should be performed first.
Targeted impact on soft tissues. Electrocoagulation should be applied in isolation, only to bleeding vessels. Do not put pressure on soft tissues or stretch them.
Using quality compression garments. This creates good compression and fixation, which prevents displacement of the skin-fat area.
Physical rest for 3 weeks.

Consequences

Suppuration. Bacteria multiply very quickly in the serous fluid and the risk of suppuration is very high. Any infection - sinusitis, tonsillitis - can cause wound infection, as it spreads through the lymph and blood.

Mucosal formation. Appears during a long course of the disease, if the seroma does not go away after surgery. It is formed both on the skin-fat flap and on the abdominal wall. If the formation of a seroma is not recognized in time, an isolated cavity with fluid will appear.

This long-term condition makes the skin mobile relative to the peritoneum. Such a seroma can exist for a very long time until events occur that provoke the manifestation of this formation.

Symptoms can often include an enlarged belly. If you start this process, suppuration will begin. The only way to get rid of such a cavity is through surgery.

If the seroma is not diagnosed for a very long time and the seroma of the postoperative suture is not treated in a timely manner, this can lead to deformation of the skin-fat area and thinning of the fiber, which will affect the appearance of the skin.

Conclusion

The occurrence of seroma after surgery is not taken into account by many, but this can ultimately lead not only to discomfort, but also to serious illnesses or simply deformation of the skin. The removal of serous fluid is quick and painless, so this should not be put off for a long time. It is easiest to prevent the occurrence of seroma in the early stages of formation than to carry out a second operation later.

Seroma is a post-surgical condition caused by the accumulation of straw-colored fluid (lymph) in the wound.

It differs in viscosity and consists of: a liquid fraction (protein) and formants, which include leukocytes, macrophages and mast cells.

If the liquid turns reddish in color, it means there is blood in it.

Why does seroma appear?

After surgical dissection of the skin, fluid accumulates between the fat layer and the intersection of the capillaries. Often this disease appears after plastic surgery, for example during a mastectomy.

Factors influencing the formation of seroma

The factors are varied, it could be:

To prevent the occurrence of such consequences and causes, before the operation the doctor checks the test results for sugar levels and coagulation. She is also interested in the presence of chronic diseases. A comprehensive examination is carried out and if pathology is detected, you will need to undergo a course of treatment before surgery.

What does seroma look like?

With a small volume of serous fluid accumulation, seroma does not manifest itself in any way and is difficult to diagnose. In the absence of bacterial infection, seroma has no odor.

Signs of its formation include:

feeling of fluid transfusion in part of the abdominal cavity;
Sometimes swelling appears and the stomach bulges out. Some people notice that their belly has become larger.

Seroma usually does not hurt.

But it happens that serous fluid accumulates in large volumes. This happens rarely, but you need to know the signs

Signs of appearance

Seroma, in addition to discomfort and pain, threatens long-term complications in the form of sagging skin where fluid has accumulated. When fluid appears, the postoperative suture will take 3 times longer to heal.

How is seroma diagnosed?

There are two methods for diagnosing the formation of serosis - examination and using instruments.

Inspection

The examination is carried out by a surgeon using the palpation method.

Swelling usually appears in the lower abdomen. On palpation, the liquid flows from one side to the other.

In combination with symptoms, a diagnosis of seroma is made, treatment is mandatory.

Instrumental method - ultrasound

The accumulation of liquid is clearly visible on it. It accumulates mainly between the anterior abdominal wall and subcutaneous fat.

Treatment of postoperative seroma

Seroma is treated in two ways:

surgical,
medicinal.

Surgical method

It is considered the easiest way to remove seroma. It is carried out using a puncture. A positive result occurs in 90% of treatment.

The surgeon pumps out liquid in a volume of up to 600 ml with a syringe. The procedure is carried out regularly every 3 days. Usually the course is 3-7 punctures.

Complex serous manifestations require 15 procedures. With each subsequent procedure, the fluid decreases. If the patient has thick subcutaneous fat, tissue trauma occurs in a large volume.

With such indicators, it will not be possible to solve the problem with a puncture. You will need to install drainage with active aspiration.

Drainage will allow the fluid to drain continuously until it disappears completely. To install the drainage system, it is soaked in antiseptic.

After connection, it is fixed with additional stitches followed by regular processing.

The drainage area itself is covered with a bandage and replaced daily.

In this case, after natural outflow, the cavity grows together and the seroma disappears. Drainage is carried out in conjunction with drug treatment.

Drug treatment of seroma

It consists of using:

After treatment

Prevention of seroma

It is always better to prevent complications from developing. To prevent the formation of subcutaneous fluid, it is enough to follow the recommendations of surgeons:

Consequences

Seroma can remain in the body for a long time and not make itself felt.

This long-term condition makes the skin mobile relative to the peritoneum. Such a seroma can exist for a very long time until events occur that provoke the manifestation of this formation.

Symptoms can often include an enlarged belly. If you start this process, suppuration will begin. The only way to get rid of such a cavity is through surgery.

It is important to understand that seroma will not resolve on its own and always requires medical intervention.

Serous fluid (seroma) is clear moisture secreted by the serous membranes of the internal cavity of the body. Its secretion is a natural result of the functioning of the body. The appearance of serous moisture is associated with the filtration of fluid in blood vessels, and therefore it contains protein, leukocytes, mesothelial cells and some other cell elements.

If there is a disruption in blood and lymph circulation, an excess amount of moisture may accumulate, sometimes accompanied by copious discharge. Most often this condition occurs after surgery. The appearance of seroma in the patient can be observed 2-3 days after the intervention. During the normal course of the recovery process, it disappears by 3 weeks after surgery. In case of further accumulation and release of transudate, additional treatment is required.

Signs of seroma formation in the body

An enlarged area of surgical intervention is the main symptom of a developing disorder. This symptom most often occurs after liposuction and plastic surgery to insert implants. After removing a huge amount of fat from the internal cavity, serous moisture begins to accumulate in the resulting voids. The implantation may be accompanied by rejection, due to which yellow liquid accumulates between the foreign element and the soft tissues.

Pathological discharge of serous fluid is determined by swelling of the surgical area. Palpation of this area can cause discomfort in the patient. Often mild pain accompanies the patient even without pressing on the swelling and can intensify with minor physical exertion. As seroma progresses to severe stages, colic becomes more intense.

One of the signs of seroma formation is skin hyperemia in the surgical area. With moderate secretion of transudate, this symptom most often does not appear. It occurs when a huge amount of excess moisture accumulates in the cavity and indicates the need for its urgent removal from the body.

Discharge of serous moisture from the suture is a rare symptom indicating a severe form of the disorder. Starting the treatment process often leads to the formation of a fistula, through which fluid flows out and begins to ooze out.

Causes of seroma development

Most often, the accumulation of serous fluid is associated with a large wound surface, accompanied by detachment of the subcutaneous tissue. The surgical intervention should be accompanied by the most delicate treatment of the internal cavity. Rough handling of fabrics and the use of low-quality tools is unacceptable. The cuts are made in one motion, quickly but accurately. The use of blunt instruments and the unsteady hand of the surgeon turns the surgical area into a “porridge” of damaged tissues that bleed and are destroyed by enzymes, which leads to the formation of a huge amount of

A large wound surface is simultaneously accompanied by destruction of the lymph nodes. Unlike blood vessels, they are not endowed with such a rapid healing ability and become scarred within 24 hours after surgery. Repeated injuries to the lymph nodes lead to increased secretion of serous transudate.

The cause of the development of seroma of the postoperative suture may be increased bleeding of internal tissues. Through small capillaries, blood enters the operated area, forming small hemorrhages. After some time, they dissolve, forming a clear liquid.

Another situation where seroma occurs is the development of a postoperative hematoma in a patient. The source of filling the cavity with blood is not capillaries, but large vessels, damage to which always leads to the formation of bruises. In this case, seroma appears only 5-7 days after surgery. Resorption of the hematoma is accompanied by the formation of fluid. It is necessary to carefully monitor the patient during the first days after surgery to monitor the appearance of small bruises that cannot be detected directly during the procedure.

After plastic surgery, implant rejection may occur. Some patients are highly sensitive to foreign elements. Taking this factor into account, manufacturers strive to use the highest quality biological materials that significantly reduce the risk of rejection. But it is impossible to predict with complete confidence the body’s reaction to the implant, and therefore, due to rejection, fluid begins to accumulate in the cavity between the pectoral muscle and the implanted element.

How to treat possible complications of seroma

Neglect of treatment for seroma is often complicated by suppuration in the operated cavity. Postoperative seroma is an ideal place for the proliferation of bacteria that penetrate the wound with lymph from the nasopharynx or oral cavity under the influence of chronic infectious diseases. Enriched with pathogenic microorganisms, the serous fluid turns into pus, which begins to poison the body.

Seroma of a postoperative scar is one of the manifestations of the inflammatory process and can be accompanied by intensive formation of connective tissue. Plastic implantation surgeries complicated by this disorder are often accompanied by the formation of capsular contracture. Rejection of an implanted foreign body activates the secretion of serous fluid, which participates in the formation of a dense layer of fibrous tissue around the implant. Gradually, the capsule thickens and begins to compress the implant, which ultimately leads to breast deformation.

A long course of pathology can lead to the formation of a serous fistula in the area of operation - a hole in thinned areas of tissue, most often along the suture line. The transudate begins to ooze through the wound on its own, thereby increasing the risk of infection and making additional surgical intervention necessary.

Excessive secretion of serous fluid prevents rapid tissue regeneration. A long course of pathology can lead to skin deformation and thinning of the subcutaneous fat layer, which reduces the aesthetic results of the intervention to nothing.

Removal of serous fluid

Seroma is treated with medication and surgery. The removal of excess serous fluid from the body after surgery is facilitated by therapy with antimicrobial and anti-inflammatory drugs. The doctor prescribes the patient to use:

antibiotics;
nonsteroidal anti-inflammatory drugs that help reduce the amount of transudate in the body;
kenagol and diprospan - in some cases, the doctor prescribes the use of steroid drugs to quickly complete the inflammatory process.

At the same time, physiotherapeutic procedures may be prescribed. The patient must independently treat the sutures with antiseptic drugs. The rapid removal of serous fluid after surgery is facilitated by the use of Vishnevsky and Levomekol ointments. The drugs are used 3 times a day by carefully applying to the surgical area.

The inadequacy of drug treatment for seroma requires surgical removal of the fluid by vacuum aspiration. This manipulation is performed in most cases of excess moisture and allows you to remove seromas with a volume of up to 600 ml. Vacuum aspiration involves inserting a thin tube into the lower area of the wound, through which the device pumps out the seroma. To completely eliminate the pathology, it is necessary to carry out the procedure every 2-3 days.

To collect more serous fluid, drainage with active aspiration is used. The manipulation consists of inserting tubes through a wound or special punctures into a cavity filled with moisture. The patient should lie down for a while so that the excess fluid gradually comes out. It is necessary to ensure constant monitoring of the progress of drainage of the cavity, and regularly carry out antiseptic treatment of surfaces close to the puncture sites.

Prevention of seroma formation

The source of the secretion of serous fluid is the lymphatic and venous capillaries damaged during the operation. The surgeon is required to perform the most careful manipulations with soft tissues.

Electrocoagulation must be used carefully, trying to cauterize only damaged blood vessels. Abuse of it can lead to burns of internal tissues, followed by necrosis and inflammation. It is important to avoid pinching and excessive tension of the skin when completing the operation.

Most of the measures to prevent the formation of serous fluid involve strict adherence to surgical rules. Their implementation allows reducing the risk of transudate up to 10%. It is necessary to carefully suture wounds, avoiding large gaps, which can subsequently become sources of infections entering the body, causing the release of serous fluid.

Any intervention is accompanied by damage to internal tissues and the release of products of the wound process (ichor), which must be removed from the body. The success of tissue regeneration largely depends on adequate drainage of the surgical site. To avoid the negative consequences of the intervention, many surgeons recommend using accordion drainage. After the operation is completed, it is necessary to place a small weight on the intervention area for a while.

To avoid complications after surgery, the patient must wear compression garments. It is recommended to use high-quality knitwear that allows for firm compression of the surgical area. Wearing compression garments prevents seams from coming apart, swelling and hernias, and promotes reliable fixation of tissues. The last factor is decisive in the prevention of seroma.

Seroma is one of the types of postoperative complications, which manifests itself in the form of accumulation of serous fluid in the area of the surgical procedure. In surgery, this phenomenon is considered a serious problem that requires immediate treatment. Otherwise, the patient runs the risk of developing dangerous complications. Therefore, at the first symptoms, you need to contact your surgeon at the clinic who performed the operation or the doctor who supervises you during the postoperative period. Postoperative seroma and the reasons for its development. Features of manifestations, prevention and main methods of treatment of this type of complication. We will look at all this today in our article.

Causes

Seroma of a postoperative scar can develop for the following reasons:

A large volume of the operation is performed, due to which a large number of lymphatic connections are mechanically damaged in a person. These vessels, in turn, cannot recover quickly, unlike blood vessels. This causes the accumulation of serous (lymphatic) fluid under the patient's skin. It is also important to note that it is the admixture of blood in the seroma that gives it its characteristic reddish tint.
Excessive tissue trauma during surgery. At the same time, this problem is usually a direct consequence of a mistake by the surgeon, who, instead of making a delicate single incision, performed several rough movements with sharp surgical instruments. In this condition, the patient experiences a large amount of tissue damage, which greatly increases the risk of developing seroma.
Squeezing tissue during surgery contributes to poor blood circulation and lymph drainage. This leads to the fact that after surgery, the impaired outflow of lymph penetrates into the tissues with triple force, thereby causing an advanced form of seroma.
Excessive use of tissue coagulation (burn) techniques. Like any burn, coagulation is accompanied by necrosis and the appearance of inflammatory fluids, which in a fairly short period can penetrate into the subcutaneous layer and give rise to the appearance of seroma.

Important! Sometimes postoperative seroma is a direct consequence of an improper rehabilitation period. For example, its appearance can be facilitated by the lack of administration of the necessary analgesics and drugs for edema, due to which nothing will prevent the accumulation of inflammatory subcutaneous fluid.

Seroma after breast surgery

It is not uncommon for seroma to develop after plastic surgery on the mammary glands. The leaders of this complication are considered to be such types of interventions as mammoplasty and mastectomy.

The rate of seroma formation after breast surgery is quite high. This is justified by the fact that it is in this part of the body that there is the largest number of lymphatic connections, which, if damaged, often lead to the accumulation of serous fluid and the development of an acute inflammatory process.

Factors that contribute to the appearance of seroma after breast surgery:

Individual reaction of the body to the installed implant. Despite the fact that most modern breast implants are made from biological materials, there is a certain percentage of women whose body still does not accept a foreign implant. This leads to an acute inflammatory process and accumulation of exudate.
Extensive damage to lymphatic vessels during surgery. At the same time, the recovery process is sometimes quite slow, which further increases the likelihood of lymph secretion and its accumulation in the soft tissue cavity.
The appearance of a large hematoma can trigger a chain reaction, during which a person will develop an accumulation of ichor. If left untreated, this process can cause seroma.
Lack of installed drainage after surgery. This is a gross mistake, which leads to the fact that the secreted lymph simply has nowhere to be removed, which is why it can penetrate into the interstitial space of the breast within a few days, thereby causing an advanced form of complication.
Negative reaction of the body to the suture materials used, which lead to fluid accumulation. This phenomenon is especially often observed during major operations and the use of a large number of absorbable threads.

Symptoms

Seroma after surgery usually occurs on the third day. It has the following symptoms and signs:

Unpleasant sensations in the wound area and pressing pain.
Feeling of fullness in the operated area.
An increase in body temperature as a reaction of the body to an acute inflammatory process.
The appearance of characteristic bulging and swelling of tissues.
Redness of the skin at the site of seroma accumulation. Also, sometimes the epidermis may acquire a bluish or purple tint in places where the seroma penetrates with blood.

Seroma in the mammary gland has the following characteristic features:

Changes in the overall shape of the breast (one breast may be larger than the other or have an asymmetrical shape).
Severe tissue swelling.
Soreness.
The appearance of serous fluid when pressing on a postoperative scar.
Redness of the skin in the suture area.

It can sometimes be quite difficult to identify this complication on your own. In this case, it is better to entrust the diagnosis to an experienced surgeon.

Treatment

Traditional treatment for seroma includes the following:

Installation of drainages is the first measure when identifying such a complication. At the same time, using a special tube embedded in the tissue, you can quickly remove accumulated fluid from the soft tissues. If the condition is advanced, the patient may need to install several drainages in different areas (along the length of the scar, on different sides of the suture).
Vacuum aspiration is the second most popular method of treating seroma. Unfortunately, this method will only be effective in case of early fluid accumulation. Vacuum aspiration is performed by attaching a tube to a special apparatus and the area where the liquid has accumulated. Using vacuum pressure, the device pumps fluid out of tissues. The disadvantage of this method is that it requires repeated dissection of the postoperative scar, which further prolongs the healing process.

Treatment with folk remedies includes the following:

If the seroma is not advanced, then you can drink medicinal liquids that have an anti-inflammatory effect. A steep decoction of chamomile and thyme works well for this purpose.
If complications develop in the lower extremities, the leg should be placed on several pillows so that blood circulation flows upward into it. This will help quickly eliminate swelling.
The use of tight compression garments or a wide elastic bandage will help the seroma resolve without surgery.

Prevention of seroma formation

In order to reduce the likelihood of this postoperative complication, it is important to adhere to the following recommendations:

Do not agree to undergo surgical intervention when the thickness of the subcutaneous fat layer in the area of the intended operation is more than 5 cm. In this case, the person first needs to eliminate excess fat deposits and only then plan the operation.
After surgical procedures (especially large-scale interventions), the patient must refrain from any physical activity for at least two weeks, which significantly increases the risk of seroma.
Dressings should be done daily using antiseptic agents.
It is important to keep the wound sterile. Also, her condition should be regularly monitored by a supervising doctor.
It is allowed to place small bags with weights on the postoperative suture. They will prevent liquid from accumulating.
For two months after surgery, the patient is recommended to use a compression bandage, compression garment or elastic bandage. Their choice depends on the specific area that has undergone surgery.
Eat a balanced diet to strengthen your immune system. This way, the body will be able to recover faster and be less susceptible to complications.
Avoid eating sweets and alcoholic beverages, which provoke inflammatory processes in the body.