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Causes and Treatment of a Seroma

Author:   Peter Sedesse MD

Causes of a Seroma

The removal of tissue from inside the body that results in a sterile blood or serum accumulation is known as a seroma. A seroma is most commonly found after a mastectomy or lumpectomy of female breasts. Cosmetic surgery that involves liposuction also frequently results in the condition. Capillary permeability is increased to dilute the location when the body notices damage to the area. The area once occupied by body tissue is filled with fluid. The fluid will gradually build up and form a palpable sac since the fluid accumulation from arteries occurs at a faster rate than the lymphatic system can drain away the fluid.

Difference between a Seroma and an Abscess

A seroma is not the same as an abscess which forms in order to fight infections. Bacteria, white blood cells and byproducts from the immune response had by the body are contained in an abscess. An infection that was correctly isolated from the other parts of the body is what is referred to as an abscess. There are no immune response byproducts or bacteria present in the sterile environment of the seroma. The seroma is the result of the surrounding tissue’s injury leading to inflammation.

Safest Treatments for a Seroma

Time is the most appropriate way to treat a seroma. The surrounding capillaries permeability will decrease as fluid fills the empty space. Shrinkage of the seroma should begin to occur as the extracellular fluid drainage by the lymphatic system is able to catch up. The lymphatic system is not equipped to handle fluid in large quantities such as happens with a seroma, so the removal of this fluid takes time. It can take a few weeks for a seroma that is the result of a mastectomy to drain by itself. When there are no complications caused by the seroma the best solution is natural drainage.

Heat and Seromas

Heat can be put on the area to speed the process along. Every few hours a hot compress or heat pad should be applied to the area for approximately fifteen minutes. The incision will be more comfortable and the fluid drainage rate will be increased. The capillary permeability will be increased as well as the seroma’s fluid buildup if the heat is left too long or the level of heat is too high.

Syringe Drainage as an Option to Treat a Seroma

A syringe to physically drain the area is the final option. The seroma has to be resulting in health complications for this method to be used otherwise it is avoided. The environment of a seroma does not contain infection or bacteria making it sterile and harmless. Bacteria are introduced as soon as the skin is penetrated by the needle and it enters the fluid; making it an actual problem because the seroma now becomes the ideal bacterial breeding ground, a sterile environment. A battleground immune response is likely to occur shortly after a needle is used to drain a seroma.

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