Post op issues.
Underneath my scar from my hernia repair and stoma reversal surgery I have a seroma, this is a complication from my surgery I had due to the Fluid not being absorbed back into my body correctly, there is a cavity from where the hernia had stretched my insides and the fluid collected in there. I had a vacuum pump on for a few days to remove the fluid after my surgery, but it stopped collecting so it was removed, and I was then sent home. After seeing my consultant in January and he explained what was going on inside and said that we should review the issue within 3 months, he didn’t really want to insert the needle into the area to extract the fluid due to the freshness of my surgery and the high risk of introducing an infection into the wound, as I hadn’t heard anything after 4 month and the seroma seemed to be growing, I had to contact them to find out if a scan or consultation was being planned.
Does it hurt,
I would say no but it does ache quite a bit later in the day, it can be very uncomfortable at times.
What is a seroma i hear you ask?
A seroma is a collection of straw-coloured fluid under the skin that can occur after an operation. It can occur when tissue is removed from the body during an operation leaving a space which sometimes fills with fluid. This space eventually gets filled with scar tissue but until this occurs the seroma can collect. The body will often re-absorb the fluid itself without any intervention, but this may take weeks to months to resolve. In some cases, if there is an excessive amount of fluid, the seroma is very painful or it is putting a strain on the stitch line from surgery, it may have to be drained and this is called a seroma aspiration. This involves inserting a needle under the skin and attaching it to a syringe to aspirate the fluid.
Why should I have a seroma aspiration?
In many cases the seroma will reabsorb. However, if the seroma is painful an aspiration can relieve the pain. If the swelling is putting strain on the stitch it may result in the wound opening and leaking if it is not aspirated.
What are the risks?
• Infection – Although every precaution is taken to avoid infection, inserting a needle into skin provides an entry point for bacteria which can lead to an infection. If you notice signs of redness, increased pain and swelling you need to seek medical intervention immediately.
• Re-occurrence of the seroma. It is common for the seroma to re-occur as the space underneath the skin where fluid collects can take some time to fill with scar tissue.
• Bleeding – There is a risk of causing bleeding when carrying out the aspiration. This will be dealt with at the time.
• Pneumothorax – There is a very small risk of pneumothorax if the aspiration is in the chest or back area. This means air enters the plural cavity and results in shortness of breath. This would occur at the time of the aspiration and would be dealt with by the team.
Are there any alternatives?
If there is no pain or strain on the stitch line most seromas will be left to re-absorb. If it is causing too much pressure on the skin that pain or wound leakage results, then it will be recommended. However, if you choose not to have an aspiration it will not be done. This may result in fluid leaking through the stitch line. In very few cases the seroma forms a capsule and becomes permanent. This can only be treated with surgery to remove the capsule but is rare. How can I prepare for a seroma aspiration? The procedure can be done in clinic. You may be asked to get a support garment to put on after the aspiration.