Doctor won't drain seroma. Need advice.

Question

I had revision surgery to fix seroma after TT. Quilting sutures, mesh and drains were used in this 2nd surgery. Drains were pulled 2 weeks after while I was still draining 80cc a day total. 5 days after drains were pulled, fluid had accumulated again (Dr said this would happen, it was expected). He seemed happy to see that my fluid collection was smaller than previous seroma. Opted to not drain it with intentions of "teaching" my body to reabsorb. Is this even possible? Will my body reabsorb it?

Nick Masri, MD, FACS · Answer

Seromas may occur after drains are pulled even if minimal amounts were accumulating. Drains are used to not "overwhelm" the body in its efforts to reabsorb some of the fluid that collects under the skin flap. 
I use an arbitrary number of cc's to decide if and when to remove the drains. That number is 30cc's a day for three consecutive days. Even then if the drains are in too long(over one month) i consider removing them dispite high outputs with the possibility that the drain itself may cause a reaction in the body creating this fluid accumulation. 
With seromas there are really no consistent methods to prevent and treat other that the ones your surgeon has chosen. Antibiotics and betadiene injections in the drains have been used to irritate the subcutaneous tissues  to stop draining as well
In the end most seromas that dont resolve must be drained so a seroma cavity does not form which may ultimately effect the outcome of your procedure. Follow up with your surgeon for further recommendations. Best Wishes

Steven Wallach, MD · Answer

If the seroma amount is very high, then it is likely your body will not resorb it. Best to be followed closely.

Praful Ramineni, MD · Answer

80 cc/day is a fairly high output to remove a drain and the body can't be "taught" to resorb a seroma.  Ideally the drain is left in until outputs are much lower (and the skin flap becomes adherent).  In cases where the drain output continues to be high, several medications (eg doxycycline) can be injected into the drain and clamped to "irritate" the wall of the seroma and make it "sticky", in order to collapse the pocket.  The drain is then removed at a future time.  Once a seroma cavity is formed and organized, it oftentimes requires removing the capsule (shell) and redraining the seroma.

Doctor won't drain seroma. Need advice.

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Doctor won't drain seroma. Need advice.

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