Should I Have a Drain Reinserted to Resolve a Seroma or Continue with Serial Aspiration?

Having to replace the drain is surely not a pleasant thought, but is a much better option than what you would need to deal with in the case that a seroma capsule were to develop. If seromas are allowed to persist, a rind of capsular tissue will form around the fluid. Often, this makes getting rid of seromas very difficult, requiring a rather aggressive surgical procedure to remove the capsular rind. You have a rather large volume seroma and I would suggest replacement of the drain as soon as possible. Before I started using progressive tension sutures for my abdominoplasties, I saw quite a few seromas. I would aspirate the seromas no more than 3 times before deciding to replace the drains. 

Thank you for your question.  That is an unfortunate situation.  With volumes as high as you describe, it is probably best treated with reinsertion of drain tubes.  As much as you don't want to have the drain tubes( which is very understandable), you don't want to develop a seroma cavity.  Once you develop a cavity there, the seroma won't have a chance to reabsorb.  This will then require another operation and more drain tubes. 

Best Wishes,

Brian Joseph MD, FACS

You have a seroma with a high volume of fluid.These can be an annoying and persistent problem. The most efficacious way to address this would be to open up a portion of your incision, completely drain all the fluid in the wound, and then leave one or even two drains in place to prevent the re-accumulation of a large volume of fluid. These drains may need to stay in for several weeks to definitively address the issue, but in the long run it will be worth it.