i had a tummy tuck 12 days ago, drains was taken out 7 days post op, 2 days later, fluid started to build up, on day 10, it became extremely uncomfortable and the drain site started to ooze lots of blood..approx 500ml oozed out. this gave me some relief, now 2 days later, its starting to swell again, i can see that its a hematoma accumulating again.. approx 150ml already, whats the best way to treat this, aspiration or surgical intervention to identify the source of the bleed?
Recurring Hematoma 2 Weeks After Tummy Tuck
Doctor Answers 8
Why Is My Abdomen Swelling 12 Days After A Tummy Tuck?
Rarely would one expect a bleed 9 days after a tummy tuck, and 2 days after the drain was removed. More than likely, you had a collection of blood which lysed (dissolved) giving you usually old coffee-grind-like material which is a dissolving blood clot. Your second occurrence of a swelling which appears to be the same material is actually a second round of lysis of the old clot. This process may go on for awhile, and unfortunately, it may lead to a seroma cavity (once the old blood is removed, the pocket in which it was held then starts producing a clear liquid and the swelling changes from a dissolving hematoma to a seroma).
Recurrent drainage of this type of lysing blood clot is rarely sufficient. A percutaneous (through the skin) in office draining system such as a Seromacath can drain the dissolving hematoma and help shut the cavity. Obviously, this requires a plastic surgeon's intervention. Please contact your plastic surgeon as soon as possible. It is not clear if you are draining the lysed hematoma by yourself or if there is a physician involved. At any rate, recurrent draining increases your chance of infection which can then decrease the aesthetic results of a good tummy tuck.
Hematoma versus seroma
You most likely have a seroma that contains a small amount of blood. It doesn't take much blood to make it all look like blood. You could also have an old hematoma that is breaking down, not actively bleeding. Either way you need to see your surgeon soon for an evaluation. You may need surgery and/or a drain put back in to resolve the problem. Don't wait another day.
Fluid build up after tummy tuck
This is not a problem you should ignore. You need to contact your surgeon urgently to determine the nature of the fluid, and that will determine what treatment you need to have. Don't delay getting hands-on evaluation of this problem!
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Recurrent fluid build up after tummy tuck- what is "normal"?
Recurrent fluid build up after tummy tuck is usually "serous or serosanguineous" In other words, the fluid is composed of blood serum and a certain amount of whole blood. This problem is typical of older (less expensive) techniques of tummy tuck surgery where the surgeon does not close the wounds on the inside (using quilting sutures that close the pocket so that there is no space for the fluid to accumulate).
Only a small amount of blood is necessary to turn the fluid pink or red, and it is often difficult, even for experienced nurses and doctors, to tell exactly how much whole blood is actually in the fluid. Having a lot of blood in the fluid would be very unusual after the first 24 hours post operatively. If you have a significant amount of blood, then you should check with your surgeon to make certain that this is normal for his or her specific technique. If it is in fact undiluted blood, then this is an emergency and you must seek medical attention immediately, since you cannot sustain that much on going blood loss indefinitely without serious repercussions.
Possible hematoma after abdominoplasty surgery
If you are continuing to ooze blood then your surgeon may have not choice but to reoperate. This could have occurred if you were placed on a blood thinning agent after surgery.
Hopefully your have or will address this matter with your surgeon. As to possible treatments, they include
- aspiration, using a syringe and needle
- insertion of a drain, through the skin under local anesthesia
- open surgical drainage.
Usually one of the first two options will suffice. Do see your surgeon. Thanks for the question, best wishes.
Talk to your surgeon about the cause of the bleed. This is not common and very unlikely. Be certain to keep your activity intensity at a low level.
I suspect that the fluid accumulation is either a blood clot that is becoming more liquid or a seroma. Either way, it is likely that you will need an exploration to remove the residual blood clot and fluid. It also sounds as if you will need drains again. See your surgeon asap.