I have a seroma and have had 3 doxycycline treatments. Still draining.

Question

I have had 3 doxycycline treatments and I am still draining 25ml a day. PS talking surgery since it seems to not be working. I am 2 months out from my TT and am sick of all of this. He is leaving it up to me without telling me what he thinks should happen next. What do I know? Should I try more doxy or do surgery? I know you can't tell me what to do but some guidance would be appreciated.

Shlomo Widder, MD · Answer

Dear K,   Sorry for your problem. Surgery is the ultimate solution, however, before resorting to it, I would recommend to aspirate the seroma weekly and apply a tight Velcro binder. That technique might cause the seroma cavity to shrink and eventually close down. Give it 2-3 weeks trial and if the amounts of fluids aspirated are going down, you are on the tight track. So, have your surgeon  continue to do it until the cavity is completely eliminated. If the aspirated fluid amounts stay the same over that initial 2-3 weeks period, surgery is your only option, unfortunately.   You did not mention where the seroma is located. If it is in the lower abdomen, the corrective procedure is relatively simple. It is more complex in the upper abdomen.    Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with flat stomach, tight and youthful looking skin, nice belly  button, improved body posture and low scar.                                                  Best of luck,                                                                     Dr Widder

Richard Baxter, MD · Answer

I am sorry to hear about your situation, I am sure it is frustrating. I think you basically have two options: One is to re-operate, take out the capsule that forms with a long term seroma, and close it with progressive tension sutures to seal up the space. The other is to place an open drain (called a Penrose) rather than closed suction drains. This will be a nuisance as it will soak into bandages but allow the space to close from the top down. I did this once many years ago before I started routinely using progressive tension sutures.

Paul C. Zwiebel, MD (retired) · Answer

Sorry to hear of your seroma/persistent drainage.Although submitting to another surgical procedure seems undesirable, it may well be your best option to assure resolution: it is the best way for your surgeon to be sure the seroma cavity is completely obliterated.

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