What is a seroma?
A seroma is an accumulation of fluid in a tissue or organ that can occur after surgery, or sometimes after an injury such as blunt trauma. The fluid, called serum, leaks out of nearby damaged blood and lymphatic vessels. Cells are typically present in the fluid, which is normally clear.
Seromas can occur after a number of different types of surgeries, especially those that are extensive or involve significant tissue disruption. These include hernia repairs, significant plastic surgeries such as breast augmentation or reconstruction, abdominoplasties (tummy tucks), and surgeries performed for breast cancer. Seroma formation may be associated with an increased risk of infection and breakdown of the surgical site.
Surgical drain tubes with bulb suction devices are used after some surgeries to help reduce the risk of seroma formation. These allow for monitoring the volume of fluid leakage, and once drainage becomes minimal, the drains are removed. Seromas can form shortly after surgery if drains are not used, and they may also occur after removal of a drain.
Small seromas often resolve on their own, although left untreated, they can calcify, forming hard knots. Larger seromas often require aspiration (removal of fluid), generally accomplished with a needle. Seromas that become infected may require antibiotic therapy and, on rare occasions, surgery may be necessary to treat a seroma.
Seromas can interfere with healing of a surgical site and may require drainage if they are large. An infected seroma can develop into an abscess, indicating the presence of serious infection. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms that suggest serious infection is present, such as pus draining from the surgical site, high fever (higher than 101 degrees Fahrenheit), severe pain, rapid heart rate (tachycardia), or if the surgical wound opens up significantly.
Seek prompt medical care if you notice a lump near the surgical site, if fluid starts to drain from the surgical site, if there is redness, warmth or swelling, or if the site feels tender. Also seek prompt medical care if you have a seroma that is being monitored and you notice an increase in its size, or if fluid drainage, redness, warmth, swelling or tenderness develop at the site.
What are the symptoms of a seroma?
Symptoms of a seroma include swelling at or near a surgical site and leakage of clear fluid through the incision. The area may or may not be painful. If infection develops, additional symptoms can include leakage of pus, redness, warmth or swelling, tenderness, or fever and chills.
Common symptoms of a seroma
Common symptoms of a seroma include:
- Leakage of clear fluid from a surgical incision
- Redness, warmth or swelling at or near a surgical site
- Tenderness near a surgical incision
Serious symptoms that might indicate a life-threatening condition
In some cases, a seroma can become infected or result in opening of the surgical site. Left untreated, these complications can be life threatening. Seek immedi ate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- High fever (higher than 101 degrees Fahrenheit)
- Pus draining from a surgical site
- Severe pain at a surgical site
- Significant separation of a surgical wound
- Uncontrollable or persistent bleeding from a surgical site
What causes a seroma?
Seromas develop as a result of damage to blood and lymphatic vessels that occurs during surgery or as the result of an injury. Fluid and cells from the damaged vessels leak into the tissues and form a soft fluid collection. Seromas are most common after extensive surgeries or those that involve disruption of a large amount of tissue, including surgeries performed for breast cancer, extensive reconstructive or plastic surgeries such as breast augmentation and abdominoplasties (tummy tucks), and hernia repairs.
What are the risk factors for a seroma?
A number of factors increase the risk of developing a seroma. Not all people with risk factors will get a seroma. Risk factors for a seroma include:
- Disruption of large amounts of tissue during surgery
- Extensive surgery
Reducing your risk of a seroma
You may be able to reduce the risk of a seroma by:
- Following any activity restrictions recommended by your health care provider
- Wearing compression garments or dressings as directed
How is a seroma treated?
Small seromas may not require any treatment as they often resolve on their own. Larger seromas often require aspiration (removal of fluid), which is usually done with a needle. Sometimes multiple aspirations are required, or a drain may be placed until fluid stops accumulating. Seromas that become infected may require antibiotic therapy and, although rarely, surgery may be required to treat a seroma.
Common seroma treatments
Common treatments for a seroma include:
- Antibiotics to treat infection
- Aspiration to remove accumulated fluid
- Drain placement to enable drainage of accumulating fluid
- Observation to monitor the seroma
- Surgery to repair the area of the seroma
What are the potential complications of a seroma?
Left untreated, a seroma can result in serious, even life-threatening complications. You can play an active role in minimizing your risk of serious complications by following the treatment plan you and your health care provider design specifically for you. Complications of seroma include: