SEROMA


DEFINITION
A collection of fluid, other than pus or blood, in a surgical wound, as a result of damage to lymphatic drainage in the area / serous ooze.
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INCIDENCE
Can occur in any person undergoing the types of surgery involved.
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AETIOLOGY
Surgical interventions
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BIOLOGICAL BEHAVIOUR

Pathophysiology
Typically occurs after operations transecting numerous lymphatic channels
- e.g. elevation of skin flaps, mastectomies, groin ops
- thereafter inhibiting lymphatic drainage from the area
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MANIFESTATIONS

Symptoms
Local
Swelling, delayed healing
May become infected.

Signs
Fluctuant, perhaps tense swelling, mobile in the plane of situation.
Assess for infection.
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INVESTIGATIONS
Aspirate.
Fluid has high H+, high CO2, low O2, low globulin compared to serum
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MANAGEMENT
Do nothing
Or aspirate.
A compressant dressing may prevent reaccumulation.
May require drain insertion.
Or even a sclerosant (eg tetracycline).
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