Lumpectomy 3 wks ago. Large hematoma 4 days post op. Any suggestions?

Question

Hematoma, the size of a peach, dripping dark blood after scab came off incision 5 days ago. Still large, and leaking steadily. Not much reduction in size. Will this resolve over time or will surgical evacuation be needed? Obv concern about infection with the open, though small, wound.?

S. Larry Schlesinger, MD, FACS · Answer

A hematoma of the size you describe open to the environment is a huge breeding ground for bacteria.  You need to call your surgeon ASAP and have the hematoma evacuated in an operating room under sterile conditions.  Hematomas occur in all specialties of surgery and the best surgeons in the world, if they are still practicing, get hematomas (hopefully rarely).  When these occur and are treated immediately, they rarely affect the appearance of the breast, rarely get infected, and heal quite well.  Conversely, if not treated expeditiously, they can lead to a true mess.  I said it already but I will say it again, call your surgeon ASAP.

Martin Jugenburg, MD · Answer

You should be in contact with your surgeon to be see in person for an evaluation. Best of luck, Regards,

Vincent N. Zubowicz, MD · Answer

The proper management of a significant hematoma is incision and drainage surgically. This will shorten the healing interval and decrease the risk of infection.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. I am sorry to hear of your post-operative complication. This needs an in-person examination today. A hematoma this large needs to be evacuated in the operating room. Please see your surgeon promptly to address this problem. Good luck.

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry to hear of your hematoma.  Though nothing replaces an in-person examination or series of photographs, a hematoma of that size should be surgically evacuated, residual bleeding controlled, and the incision closed.

Keith Denkler, MD · Answer

Check with your doctor.The blood will need to be removed and the area should be cleaned up.This can be done usually under local anesthesia.Photos will help.

Lumpectomy 3 wks ago. Large hematoma 4 days post op. Any suggestions?

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