Seroma After Hernia and Diastasis Repair

Question

Surgery 2 wks ago to repair a large diastasis recti & umbilical hernia. 3 days later, I developed a mild fever and was sent to the ER. They did a CT scan and noticed a large seroma with a small air pocket which they believed to be the start of an infection, was given antibiotics. I have since had it drained a total of 3x's. Each time removing around 400 ccs. Most recent aspiration was this morning & after a few hours feels full again. Surgeon wants to see me in 2wks. Any thing else I can do?

Vincent N. Zubowicz, MD · Answer

Seromas are occasional complications after abdominoplasty and are usually dealth with by serial aspirations in the office. If they don't resolve in a few weeks, a chronic capsule can form that may require surgical excision if the problem is to be definitely solved.

Otto Joseph Placik, MD · Answer

Once a seroma develops, it should generally be treated until it resolves. This can take a weeks or sometimes several months in certail individuals. The scar tissue that forms around a seroma can also be very tight and because of the delay in healing due to the fluid, it can delay healing in this area and remain firm when the rest of your abdomen feels healed and soft. Generally speaking, it does resolve and slowly return to normal.

Robert Brueck, MD · Answer

Sometimes they go away after a few aspirations but sometimes they require opening it up and maybe putting in some quilting sutures to obliterate the dead space.as long as you are afebrile all should be well.

Steven Wallach, MD · Answer

Sometimes fluid collections or seromas develop after a tummy tuck. They suually go away after repeated aspirations.

Samer W. Cabbabe, MD · Answer

You will need continued aspirations until this resolves. It may also help to wear a compression garment to decrease the risk of re-formation. If this continues to be a chronic issue, you may need surgery to remove the seroma cavity that forms.

Peter A. Aldea, MD · Answer

Regarding: "Seroma After Hernia and Diastasis Repair
	Surgery 2 wks ago to repair a large diastasis recti & umbilical hernia. 3 days later, I developed a mild fever and was sent to the ER. They did a CT scan and noticed a large seroma with a small air pocket which they believed to be the start of an infection, was given antibiotics. I have since had it drained a total of 3x's. Each time removing around 400 ccs. Most recent aspiration was this morning & after a few hours feels full again. Surgeon wants to see me in 2wks. Any thing else I can do?"

	A small air pocket found in a fluid collection 3 days after surgery is most likely air left after surgery and not gas produced by the germs. Nonetheless, in the presence of fever it was proper to treat you with antibiotics even tough the most likely source of the infection all things being the same was probably your inability to fully take full breaths and expand your lungs.

	Seromas can be very frustrating to the surgeon and especially to the patient. Most surgeons when faced with a highly draining seroma would drain it with syringe aspirations several times a week and NOT once every other week. By frequent aspirations the seroma volume is kept low and its walls are kept close together allowing them to stick to one another and obliterate the pocket. If this does not work, the options are to re-place a drain in the seroma for continuous drainage or to re-operate and remove the scar wall of the seroma pocket to promote wall adherence. You may wish to discuss your surgeon's plans with him so you can feel more comfortable.

	Dr. Peter Aldea

Victor Au, MD (retired) · Answer

This problem is best treated by serial aspirations. I have been lucky not to have had any large seromas in my tummy tuck patients, and so far (knock on wood) have not had to re-operate on any. I usually leave the drains in until they have almost nothing draining out, and I usually remove one at a time. If a seroma becomes infected, the amount of drainage can escalate dramatically. Once the infection is under control with the right antibiotics (they probably took a culture of the fluid) the drainage should slow down allowing the walls to close and seal. I would think that if it fills rapidly then it might be best to have it aspirated frequently, and as the other have stated, placement of another drain might be necessary. Call your Doctor if you have concerns about it re-filling rapidly so he can drain it out, sooner rather than later. I would not wait 2 weeks if it has already filled up.

Seroma After Hernia and Diastasis Repair

Answers (7)

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