Seroma: Things to know

A seroma is a fluid buildup in an area of the body where tissue has been removed. Seromas are frequently a consequence following surgery, although they can also develop as a result of an injury.

Seromas are usually not harmful, and doctors let them heal on their own. They have little resemblance to cancer cells and represent no additional risk or concern. They can, however, cause discomfort and result in a lengthier hospital stay after surgery.

According to one study with 150 participants, 49 percent of the patients had a seroma after breast surgery. Another study discovered that 20% of individuals had seromas evident on a CT scan 6 months following surgery.

When to consult a doctor

It may take several weeks for the seroma to absorb on its own. As long as no difficulties emerge, allowing a seroma to absorb on its own is the best method to heal spontaneously.

If the seroma does not improve or if the symptoms worsen, the patient should see a doctor.

A doctor may need to drain the seroma if:

  • it puts excessive pressure on the area of surgery or injury, the skin, or an organ
  • it becomes painful
  • there are signs of infection or inflammation, such as redness, warmth, or tenderness
  • it gets bigger
  • the amount of fluid seems to be increasing
  • there is no improvement

Seromas can increase the risk of surgical site infection, so they must be closely monitored.

A seroma may need to be drained more than once, depending on its severity.

Causes

seroma

The exact causes of seromas are unknown, however they are common in the breast area of people who have had breast cancer surgery.

Other procedures that can cause in seromas include:

  • plastic or cosmetic surgery
  • breast reduction
  • plastic reconstructive surgery
  • breast implant
  • breast biopsy

Seromas form as a result of the body’s reaction to dead space within tissue that was linked to something before to surgery.

Seromas are common following surgical procedures or everywhere there is a skin rupture, according to surgeons.

Risk factors

A seroma can occur as a result of a number of circumstances. These are some examples:

  • use of drugs called heparin or tamoxifen
  • body mass index
  • breast size
  • age
  • previous biopsy surgery
  • presence and number of cancerous nodes in the armpit

How do seromas develop?

Seromas typically emerge 7–10 days following surgery, once the drainage tubes are withdrawn. The surgical sites may develop swelling patches that feel like liquid under the skin.

Surgery causes the blood and lymph vessels, as well as the surrounding tissue. Inflammation develops, and the severed arteries and tissues release clear fluid as a result.

This is why there is swelling and pain following surgery. In some situations, the fluid condenses and forms a pocket, resulting in the creation of a seroma.

Performing surgery in a method that minimizes the risk of leaving dead space can also lower the likelihood of a seroma developing.

Seromas cause lumps to grow beneath the skin. These are filled with serous fluid, a yellowish to white fluid. This is the same fluid that can be seen in blisters and fresh cuts.

The lumps can be analyzed to see if they contain serous fluid rather than pus, blood, or another fluid.

Conditions that are similar to seromas

There are certain conditions that are sometimes misdiagnosed as seromas:

Hematoma: This is a gathering of blood in the body’s dead space. It is usually caused by a tiny blood artery rupturing while a person is recovering from surgery. Hematomas may need to be drained since they can cause pain, scarring, and infection.
Lymphocele: This is an abnormal accumulation of lymphatic fluid following a surgical treatment.
Abscess: This is a painful collection of pus caused by a bacterial infection. Pus is a viscous fluid made up of white blood cells, dead tissue, and bacteria. The majority of abscesses originate beneath the skin, however they can also occur inside the body in an organ or a gap between organs.

Home remedies

Most seromas recover on their own. They are often reabsorbed into the body within one month, although this can take up to a year.

In more severe situations, they can take up to a year to be digested, or they can form a capsule and remain until surgically removed. Once the seroma has healed, the region may harden.

Heat can be applied to the affected area to help it heal faster. Every few hours, a heating pad or hot compress can be applied for around 15 minutes. This aids in fluid drainage while also offering extra comfort to the incision area.

People should ensure that the heat is not excessively hot and that the compress is not left on the affected area for an extended period of time. Excessive heat can cause further fluid collection in the seroma.

Depending on the area affected, keeping the area high may also aid in drainage.

Treatment

Fine needle aspiration can be used to draw off fluid.

To empty the region, a technique known as fine-needle aspiration is occasionally utilized. It’s also a fantastic technique to keep track of how much fluid is leaking.

If seromas become a recurring issue and must be drained frequently, one solution is to install a drainage tube to keep the region free.

Drainage raises the danger of infection and should be conducted by a medical practitioner in a clean environment.

Prolonged drainage might increase the risk of infection and slow the healing process even more.

Surgical risks

In other cases, leaving the seroma alone may be the best decision. One concern for cancer patients is that seromas can sometimes delay additional cancer therapies.

Seromas are increasingly frequently regarded as a side effect of surgery rather than a problem, however they do not occur in all individuals.

Seromas typically occur immediately after surgery when drains are not used. A seroma might develop up to one month after surgery and drain removal.

Though seromas are a common surgical complication, there are some steps that may be taken to assist prevent them from occurring.

One of the main alternatives for reducing seroma formation is to use closed suction drainage for several days. New strategies are being developed to limit the amount of dead space formed in order to assist avoid the formation of seromas.

Recovery

Following surgery, the treated region is frequently wrapped in a tight bandage. Dressings help to keep the region clean and bacteria-free. They help restrict it from stretching and reduce fluid accumulation.

Following a mastectomy, lumpectomy, or even a breast reduction, the patient is instructed to wear a tight bra to apply pressure to the surgical site. This reduces the likelihood of fluid leaks and speeds up recovery.

Patients are advised to wear compression garments for at least two weeks following surgery and to gently massage the area to assist get the fluid out.

It is important to keep the wound clean in order to keep bacteria and other germs at bay. Another important strategy to avoid the formation of seromas is to prevent infection at the surgical site.

A minor buildup of fluid is normal following surgery and does not always indicate the presence of a seroma.

Infected sarcomas can be drained and treated with antibiotics or other medications, and the patient will recover completely.

Although most seromas are harmless, patients should be aware of them. Patients should see a doctor if a seroma grows to be exceedingly large or if any other issues arise. People who are having surgery should be aware of the warning signs and symptoms.

Sources:

  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4867130/
  • http://www.diva-portal.org/smash/get/diva2:974425/FULLTEXT01.pdf
  • https://pubmed.ncbi.nlm.nih.gov/32595401/
  • http://www.jbd.or.kr/journal/view.php?number=26
  • https://www.medicalnewstoday.com/articles/312875
  • http://www.breastcancer.org/treatment/side_effects/seroma
  • https://academic.oup.com/asj/article/37/3/301/2640531
  • https://pubmed.ncbi.nlm.nih.gov/33517291/