Had a bilateral mastectomy with free flap reconstruction. At 5 weeks from surgery the last JP tube was removed because it was there too long but was still draining 200ml daily. On week 6, an ultrasound guided tube was inserted. I'm near week 8 and two days ago the drainage output was 260ml; yesterday 60ml; it goes up and down. This seem to never end. Have a dr's appointment in a few days, but I am very frustrated. What is done in these cases? Thank you.
What's the best procedure for eliminating a "complex" abdominal seroma?
Doctor Answers 3
Seroma after Abdominal Surgery
This can be frustrating and delay a person from getting back to their normal activities and routine.
Seroma is the medical term for a collection of serous fluids after surgery. Drainage tubes are typically placed until the output is low. This might be less than 30 cc per day. Fluid accumulation can occur upon drain removal.
Unfortunately, there is no perfect time to remove the drains. If the output is too high and the drains are left in a long time then infection can occur.
In cases with persistent output, the doctor can consider a sclerosing agent. This is a medication that causes the lining to get inflamed and then the lining sticks to the opposit side- closing off the space.
There are different medicines used. I have had success with sterile talc. Talc is used to cause the sclerosis and close the pocket. I have had many successful treatments after tummy tuck operations and seroma formation. It is safe and highly effective.
Talc is also used for sclerosing the pleural cavity (lung cavity) in cases where patients have recurrent pleural effusions (water on the lung).
Talk to your doctor about your options. I hope this helps.
Dr Chris Saunders
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I agree with the comment about Doxycycline. However, the results have been mixed. For definitive resolution your surgeon may talk to you about going back to surgery in order to remove the pseudo bursa (slick pouch-like surfaces that secrete the fluid but wont stick together). I have done this twice ( 10 and 15 years ago) after the conservative efforts failed. Surgery usually works but you may have the drain re-inserted for a short time.
Post op seroma
Some surgeons consider sclerosing a post-op seroma pocket with Doxycycline which is an antibiotic. This can inflame the walls to the point where they stick to each other.