How to Identify a Seroma & Can Seromas Cause Complications?

A seroma is an accumulation or buildup of fluids in any particular place on the body from where tissue has been removed. Seromas typically occur as a complication following surgery, but they can also develop after a wound or injury. It mostly develops at the site of the incision or at the place from where the tissue was removed during surgery. In the majority of cases, seromas are usually harmless and tend to heal naturally over a period of time. Seromas are also not related to cancer cells and pose no risk or concern. However, they can lead to a longer stay in the hospital after your surgery, and they can also cause some discomfort. But what are the causes of seromas, and why do some people get it and some do not? Read on to find out what is a seroma and what causes it.

What is a Seroma?

What is a Seroma?

A seroma is an accumulation of fluid that builds up just underneath the surface of your skin, especially after a surgery. They usually develop at the site of the incision made for the surgery or at the location from where tissue has been removed during the surgery.

This collection of fluid, known as a serum, does not build up overnight and takes time to start accumulating. The fluid and swelling may even start building up a couple of weeks after you have had your surgery.

Seromas do not pose any serious health risk, but they can cause discomfort and also prolong your hospital stay after your surgery.

A study carried out on 158 participants by the Iranian Center for Breast Cancer found that nearly 35 percent of patients developed a seroma after undergoing surgery for breast cancer.(1) Another study published in the Journal of Breast Disease in 2014 found that 20 percent of women had seromas that were clearly visible on a CT scan within six months after undergoing surgery for breast cancer.(2)

How to Identify a Seroma?

How to Identify a Seroma?

In most cases, a seroma has the appearance of a swollen lump, similar to a large cyst. It could be tender, and it may feel sore when you touch it. It is also common to experience a clear discharge from the site of the surgical incision when there is a seroma present. You might also develop an infection if this discharge starts becoming bloody, develops an odor, or starts changing color.

In some rare cases, a seroma may go on to calcify. This means that you will be left with a hard knot at the site of the seroma.

Are There Any Risk Factors for Developing a Seroma?

There are many factors that increase the risk of developing a seroma after undergoing surgery. However, not everyone who has these risk factors will go on to develop a seroma. These risk factors are as follows:

  • Extensive surgical procedure
  • A procedure that removes or disrupts a large amount of tissue
  • Having a history of seromas after surgical procedures
  • Age
  • Previous biopsy surgery
  • Use of drugs known as tamoxifen or heparin
  • Body mass index (BMI)
  • Breast size
  • The presence of cancerous nodes in the armpit

Can Seromas Cause Complications?

Can Seromas Cause Complications?

While generally seen to be benign, a seroma might cause complications if it drains externally onto the skin’s surface. This does happen sometimes. If this happens, then you need to ensure that the drainage is clear or just slightly bloody. If you start experiencing signs and symptoms of an infection, then it might be possible that the seroma has developed into an abscess.

If it develops into an abscess, then you will need medical treatment. An abscess is unlikely to resolve or disappear on its own, and it might continue to grow in size, increasing your discomfort over a period of time. The infection might also make you very sick, and it becomes especially dangerous if the infection spreads to the bloodstream. This, then, puts you at risk of developing sepsis or you may become severely ill.

Signs and symptoms of having a serious infection include:

  • Confusion
  • Fever with chills
  • Rapid heart rate
  • Rapid breathing
  • Sudden changes in blood pressure

When to Seek Medical Help?

It is very rare to hear about someone having some type of serious or long-term problems stemming from a seroma. However, if you experience any of the following symptoms, then you should seek emergency medical attention:

  • A fever that exceeds 100.4oF
  • Very bloody or white discharge from the seroma
  • Increasing redness around the seroma
  • Increasing pain
  • Swelling that seems to be growing rapidly
  • Rapid heart rate
  • The skin around or on the seroma is warm to touch

If the swelling from the seroma causes the surgical incision to open up or if you notice that there is pus draining from the site of the incision, then you should head to your nearest emergency room or call for emergency medical assistance.

Can Seromas Be Treated?

Can Seromas Be Treated?

Small or minor seromas do not typically need any special medical attention or treatment. This is because the body itself naturally reabsorbs the fluid that has accumulated within a couple of weeks or months.

Medication, also, will not make the fluid disappear any faster, but you might take some over-the-counter (OTC) pain medications such as Advil (ibuprofen) to reduce any pain or discomfort you are having. This will also help alleviate any inflammation you are experienced due to the seroma. However, discuss with your doctor first before taking any medications.

In cases or larger seromas, you might require treatment from a doctor. Your doctor may recommend draining the seroma, especially if it is becoming quite big or if it is too painful. In order to do this, your doctor will simply insert a needle into the seroma and remove the excess fluid buildup with a syringe.

Your doctor might also need to drain the seroma in the following circumstances:

  • The seroma is getting bigger
  • The amount of fluid inside the seroma seems to be increasing
  • There is no improvement even after waiting for a couple of months
  • The seroma is putting excessive pressure on the area of injury or surgery, the skin, or even an organ
  • The seroma becomes painful
  • There are signs of inflammation or infection, including warmth, redness, or tenderness.

Seromas may return, and it might be necessary that your doctor has to drain a seroma multiple times. In some cases, your doctor might even recommend that you have the seroma removed completely. This will be done with a small surgical procedure.

Conclusion – Can You Prevent Seromas?

After some surgeries, your doctor might consider putting in surgical drainage systems in place to prevent the development of a seroma. Before you undergo surgery, however, you should first discuss the likelihood of having a seroma develop with your doctor and also understand what you can do to help prevent the development of a seroma.

Asking your doctor about compression garments is a good idea. These are medical devices that have been designed with the purpose of helping tissue and skin heal faster. These compression garments are known to significantly reduce the risk of developing a seroma.

Taking such small steps might help prevent the development of a seroma after you have had a surgery. If a seroma does develop, then you should let your doctor know and also keep checking in with your medical team or doctor from time to time about the condition of the seroma so that the best steps to be taken for treatment (if required) can be taken without any delay.

Though they are bothersome, it is very rare that seromas are a serious medical condition. So you should rest assured that it will eventually heal on its own.

References:  

  1. Hashemi, E., Kaviani, A., Najafi, M., Ebrahimi, M., Hooshmand, H. and Montazeri, A., 2004. Seroma formation after surgery for breast cancer. World journal of surgical oncology, 2(1), p.44.
  2. Park, S.Y., Kim, E.Y., Park, H.K., Chun, Y.S., Nam, S.Y., Kim, J.H. and Choi, H.Y., 2014. Computed Tomographic Findings of Postoperative Seroma in Breast Cancer Patients. Journal of Breast Disease, 2(2), pp.64-68.
  3. Tadych, K. and Donegan, W.L., 1987. Postmastectomy seromas and wound drainage. Surgery, gynecology & obstetrics, 165(6), pp.483-487.

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