11/25/2023 0 Comments Serosanguinous fluid after surgery![]() ![]() Surgical procedures with extensive soft tissue dissection are more likely to transect blood and lymphatic vessels and lead to a transudative fluid collection. Current hypotheses from different studies indicate a likely multifactorial origin of this fluid collection. The exact pathophysiology of seroma formation is not yet fully understood. It is thought this delayed form of healing plays a role in the formation of seroma due to a prolonged phase of the first phase of wound repair. Decelerated angiogenesis and epithelialization make this a slower mode of healing and more likely to result in chronic wounds or infection without good wound care. This occurs through the formation of granulation tissue (consisting of fibroblasts, new blood vessels, and type III collagen) with overlying epithelialization and extensive remodeling. Disruption of this process through infection, hypoxia, or dehiscence will lead to secondary wound healing. This occurs over three overlapping phases: hemostasis/inflammation, proliferation, and maturation. Surgical wounds will heal through primary intention in the presence of well-approximated tissues and the absence of infection. Īlthough current research trends are focussed on prevention, the mainstay of postoperative management of seroma includes conservative measures and fine needle aspirations. They are also associated with an increased risk of wound infection and possible abscess formation. ![]() Local wound complications can occur, such as wound dehiscence and flap necrosis, requiring further surgical intervention. These fluid collections can cause pain and anxiety for the patient necessitating further outpatient and hospital visits, leading to increased cost of care. The etiology of seroma formation remains unclear but is thought to be due to disruption of lymphatic and vascular drainage through extensive soft tissue dissection with an accumulation of serum, and possibly inflammatory exudate, in a dead space. It is a common complication of breast cancer surgery, plastic surgery, and abdominal wall hernia repair, with rates ranging between 15 to 85% following mastectomy and a global prevalence of 10.9% following abdominoplasty. Seroma is the abnormal accumulation of serous fluid in a dead space containing plasma and lymphatic fluid. ![]()
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