How Long is Too Long to Wait to Drain an Abdominal Seroma? I Am Almost 3 Weeks Post Op and Ten Days Post Seroma.

Question

I was out of town when the seroma developed. I just got back and the dr. will drain it tomorrow but I had to wait ten days because I was away. Is this too long and have I jeapordized having a good outcome because of the 10-day wait? It developed my first day out of town; I think there is a quite a bit of fluid sloshinga round my lower abdomen right now. I had a hematoma on flank which seems to have fully resolved on its own, did this cause the fluid though?

Kurtis Martin, MD · Answer

Some seromas last for months so don't worry about a few days. Most resolve in a few weeks and don't cause any long term problems.

Richard J. Bruneteau, MD · Answer

Seroma formation is a common problem following tummy tuck
surgery.In an effort to minimize this
complication, surgeons utilize drains in the post-operative period.These drains are typically left in place for
7 to 14 days following surgery.They are
usually removed when drainage drops below 25 cc per 24 hours.After
the drains are removed, seroma fluid can continue to develop for a limited
period of time.In most cases, the body
reabsorbs this fluid before it can develop into a seroma.In some cases, this fluid accumulates faster
than the body’s capacity to reabsorb it.When this occurs, seroma formation can result.This occurs more frequently when patients are
physically active.Once a
seroma forms, serial percutaneous aspirations with a needle and syringe are
necessary.If this continues,
percutaneous CT-guided drain placement may be necessary.In rare cases, placing a sclerosing agent
into the seroma cavity may be necessary to prevent seroma formation. Although
most seromas don’t represent a significant problem, they should be
removed.Seroma removal helps decrease
the potential for infection and wound breakdown.It also makes recovery a more comfortable
experience.The vast majority of seromas
have resolved in 6 weeks but occasionally they persist for longer periods of
time.Clinically significant seromas can
usually be felt on physical examination.Lesser amounts of seroma may be present in most patients but these don’t
require treatment.A 10-day delay in
treatment probably won’t affect your final result.

David Stoker, MD · Answer

It is better to drain your seroma sooner rather than later, but one to two weeks probably will not impact your final outcome as long as the seroma resolves completely.

Vincent N. Zubowicz, MD · Answer

A seroma should be aspirated as soon as it is diagnosed. Frequent aspirations will shorten the duration of the problem.

David Shafer, MD, FACS · Answer

There really is no right or wrong with seroma treatment as long as you are followed closely with your surgeon. I prefer to treat seromas when then appear or as soon as possible, but sometimes circumstances like yours occur and patients patients do just fine after one drainage. Occasionally patient's will need additionally drainage. Seromas, in general, are area, but when they do occur are easily treated with drainage and rarely require more extensive intervention.

David Mattos, MD · Answer

How often surgeons drain seromas and how often they follow them for repeat aspiration, if necessary, is surgeon and office dependent. In general, I like to see patients who have seromas every week so that I can drain the seroma repeatedly and place the patient in compression to try to minimize the risk of it redeveloping. If 10 days go by there is no evidence that it's any different. I wouldn't wait a month but 10 days should still be within the acceptable window. 
-Dr. David Mattos, New York Plastic Surgical Group

Chad Robbins, MD · Answer

Hello and thank you for your question .    You won't have any long term issues or changes in your results.  Some have them for a month or more.

C. Bob Basu, MD, MPH, FACS · Answer

Please followup with your PS as scheduled.  I wouldn't worry.  It may require a few treatments to get your seroma under control.  Wishing you a speedy recovery.

Sugene Kim, MD, FACS · Answer

Usually once we discover seroma, we would like to aspirate the fluid relatively soon afterward.  As seroma stays in the body for a period of time, our body will form capsule (bursa) around the fluid; this can lead to a chronic problem.  Now that you are back in town, follow up with your plastic surgeon closely.  He/she will treat you as warranted.. 

	I double that a hematoma caused your seroma.

Paul Gill, MD · Answer

I do think that your seroma can be safely treated with prompt attention by your plastic surgeon.   Generally, the longer the seroma has been present, the more difficult it is to heal.

	I would recommend staying in town as much as possible until this resolves to allow your plastic surgeon to closely monitor your recovery.

How Long is Too Long to Wait to Drain an Abdominal Seroma? I Am Almost 3 Weeks Post Op and Ten Days Post Seroma.

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