What are the procedures for hematoma aspiration?

From the Guidelines

Aspirating a hematoma is generally not recommended unless there is increased tension on the skin, as it may introduce skin flora into the pocket and lead to infection 1.

Pre-Aspiration Procedures

The skin should be cleaned with an antiseptic solution, and a local anesthetic may be administered to reduce discomfort.

• Sterile technique: The procedure should be performed under sterile conditions to minimize the risk of complications.
• Needle selection: A suitable needle and syringe should be used for aspiration.

Aspiration Procedure

The hematoma should be aspirated slowly and gently to avoid causing further damage to the surrounding tissue.

• Aspiration technique: Gentle aspiration is recommended to avoid introducing air into the pocket or causing further damage.
• Avoiding pressure: Avoid applying manual pressure over the extravasated area, as this may push the hematoma further into the tissue.

Post-Aspiration Care

After aspiration, the area should be compressed with a sterile dressing to prevent re-accumulation of the hematoma.

• Dressing: A sterile dressing should be applied to the area to prevent infection and promote healing.
• Monitoring: Patients should be monitored for signs of infection, such as increased redness, swelling, or fever, and advised to follow up with their healthcare provider if they experience any concerns. In some cases, aspiration may need to be repeated, and patients may require pain management with medications, but it is crucial to consult with a healthcare provider for personalized guidance and treatment 1.

From the Research

Hematoma Aspiration Procedures

The procedures for hematoma aspiration vary depending on the location and type of hematoma. Some common procedures include:

• Aspiration with an 18-gauge catheter, followed by application of a compression dressing 2
• Haematoma paracentesis, which involves measuring intra-articular pressure before and after aspiration 3
• Ultrasound-guided aspiration, which can be used to evaluate the safety and efficacy of aspiration and determine the optimal time frame for aspiration 4
• Arthroscopic shaving, which can be used to evacuate a large hematoma after total knee arthroplasty 5
• Aspiration after sealing the entrance by stenting, which can be used to treat subintimal hematoma 6

Key Considerations

Some key considerations for hematoma aspiration include:

• The use of local anesthesia, such as 1% lidocaine, to minimize pain and discomfort 2
• The importance of measuring intra-articular pressure before and after aspiration to evaluate the effectiveness of the procedure 3
• The use of ultrasound guidance to improve the accuracy and safety of aspiration 4
• The potential risks and complications of aspiration, such as infection and further vessel damage 5, 6

Efficacy and Safety

The efficacy and safety of hematoma aspiration have been evaluated in several studies. For example:

• A study published in the Clinical Journal of Sport Medicine found that aspiration with an 18-gauge catheter was a simple, cost-effective, and effective method for managing auricular hematoma 2
• A study published in the Journal of Injury found that haematoma paracentesis resulted in a significant decrease in intra-articular pressure and pain relief after Mason I radial head fractures 3
• A study published in the American Journal of Roentgenology found that ultrasound-guided aspiration was a safe and effective procedure for treating musculoskeletal hematomas 4