A seroma is a collection of clear, yellowish fluid that builds up in the body, typically in a space where tissue has been removed, such as after surgery or an injury. While often appearing as a noticeable swelling, a seroma is generally not a collection of blood or pus. Seromas are a common outcome, particularly following procedures like breast surgery, plastic surgery, or hernia repair.
When Seroma Drainage is Necessary
While many small seromas may resolve on their own as the body naturally reabsorbs the fluid over several weeks or months, larger or symptomatic seromas often require medical intervention. Symptoms indicating the need for drainage include significant swelling, pain, discomfort, or pressure on surrounding tissues. A seroma might also cause tightness of the skin, restrict movement, or present cosmetic concerns.
Leaving a seroma untreated can lead to various complications. An enlarging seroma can strain the surgical incision, potentially causing the wound to open and leak fluid. Untreated seromas also carry an increased risk of infection, which can develop into a painful collection of pus called an abscess. Additionally, prolonged fluid collection can delay wound healing or, in some cases, lead to the formation of a fibrous capsule around the seroma, making it harder to drain later.
Healthcare Professionals Qualified to Drain Seromas
Seroma drainage is a medical procedure that should always be performed by a qualified healthcare professional in a clinical setting. Attempting to drain a seroma at home is not recommended due to the significant risk of infection and other complications. The specific professional who drains a seroma often depends on its size, location, complexity, and the healthcare environment.
Surgeons, especially those who performed the initial procedure, are typically the primary specialists to address a seroma. This includes general surgeons, plastic surgeons, and orthopedic surgeons, depending on the type of surgery that led to the seroma’s formation. They possess detailed knowledge of the patient’s anatomy and the surgical site, which is beneficial for effective drainage.
Primary care physicians may assess smaller, uncomplicated seromas and can perform drainage in some cases, or they may refer patients to a specialist. Advanced practice providers, such as Physician Assistants (PAs) and Nurse Practitioners (NPs), are also qualified to drain seromas within their scope of practice and often under physician supervision. These professionals are trained in sterile techniques and managing potential complications, ensuring patient safety during the procedure.
Understanding the Seroma Drainage Process
Seroma drainage is typically an outpatient procedure performed in a clinic or office setting. The most common method for drainage is needle aspiration. During this process, the healthcare provider will first cleanse the skin around the seroma to minimize the risk of introducing bacteria.
A sterile needle is then inserted into the seroma, and the serous fluid is gently drawn out until the area is flattened or no more fluid can be removed. While some discomfort may occur, the procedure is often not overly painful, especially if the area is still numb from the original surgery.
Post-Drainage Care and Potential Issues
After the seroma drainage, a small dressing is applied over the puncture site. Patients are advised to monitor the area for any changes and to keep the site clean and dry to prevent infection. Specific instructions for wound care, including when it is safe to shower and how to manage any surgical dressings, will be provided by the healthcare team.
It is common for seromas to re-accumulate fluid, sometimes requiring multiple drainage sessions over several weeks or months. The recurrence happens because the underlying space needs time to heal and fill with scar tissue.
Patients should watch for signs of infection, such as increased pain, swelling, warmth, or redness around the drained area, or pus draining from the site. Fever, chills, or a rapid heart rate are also indicators that immediate medical attention is needed.