How Do We Resolve This Seroma?

I had an incisional median hernia repair, component separation and a double layer of Permacol inserted, resulting in a "seroma" the size of my abdomen, skin and bellybutton detached from the muscle layer, recurrence of the hernia, and bulging of muscles on the right side aches on walking. I'm allergic to rubber and have discovered that Permacol is cross linked with polyurethanes (diisocyanates), and does not resorb. Biomaterial was used to avoid rubber chemicals.

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seroma detachment hernia repair

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5 Doctor Answers | Asked by Seromaria

Doctor Answers (5)
Community Comments (1)

Get other opinions for tummy tuck complications.

Hi. Sounds really difficult. You need two other opinions about how to proceed. First, I would recommend an interventional radiologist to drain the seroma.

Failed Hernia Repair

A repeat hernia repair is best performed after at least 9 months since your last intra-abdominal procedure because the adhesions to the bowel are easier and safer to handle. Your components separation most likely has been maintained and will not be repeated. You will need the seroma and hernia sack removed, the appropriate mesh needs to be placed as well as plenty of drains to minimize fluid build up and to allow the skin, fat and muscle to heal together. Good luck. more

Large Seroma after Components Separation and Midline Hernia Repair

Permacol is a porcine acellular graft used for strength and claimed by the distributor to be more likely to retain strength than human acellular dermal autograft. Whoever is taking care of you will likely be considering how to avoid recurrence after what sounds like a very thoughtfully planned operation. Seromas are treated by drainage, until they stop filling up. This is the routine procedure if they occur after a tummy tuck. Studies find an average of 3.5 aspirations to... more

How Do We Resolve This Seroma?

This is obviously a complex problem, and there is not enough info here to make any firm recommendation. When was the surgery? Were there drains? Has this been aspirated? Has a new drain been inserted? Has there been an attempt at sclerosis? How do you know that the hernia has recurred? It is not too likely that without further info that you will get much usable advice online. Seeing you surgeon is where you should start, and if you are not content with the treatment plan, a second... more

Seroma after Component Separation

The component separation technique is preferred over mesh techniques and has been one of the more successful innovations in the field of hernia repair. However, the issue of seroma in your case must be addressed. This is a complex issue that needs to be addressed by the surgeon or surgeons who performed the operation.

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Comments (1)

Seromaria 9 Jan 2013

Thanks for the excellent advice. To answer your questions: the surgery was performed 10 months ago, 2 vertical VACs for first 5 days, radiographic drainage was done after about 8 weeks on my insistence, no attempts at sclerosis were made, a CT scan at 8 months confirmed my suspicions of recurrence of hernia, and yes I am sure it is a bursa without a joint. My right side bulges on standing and on coughing, and there's a pannus because of skin detachment from underlying layers. I've been very sedate ever since surgery.

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