From the Guidelines
No, a hematoma and a contusion are not the same, though they are related injuries. A contusion is a bruise that occurs when small blood vessels under the skin rupture but the skin remains intact, causing discoloration, pain, and swelling. A hematoma, as described in the study 1, is a more severe injury where blood collects and pools in a specific area, forming a mass or lump, often resulting from infiltration of the vein or leaking of blood around the puncture site during cannulation.
Key Differences
- A contusion typically resolves on its own with rest, ice, compression, and elevation (RICE), whereas hematomas may sometimes require medical intervention, especially if they are large or located in sensitive areas.
- Hematomas involve more significant bleeding and collection of blood in tissues, which can lead to complications such as thrombosis of the AV access or stenosis at the site of hematoma, as noted in the study 1.
- The distinction between hematomas and contusions matters because hematomas can sometimes create pressure on surrounding tissues and require more urgent medical attention than typical contusions.
Clinical Implications
- Management of cannulation complications such as infiltration and resulting hematoma is dependent on the extent of swelling, pain, and patient anxiety, as discussed in the study 1.
- Providing comfort measures and/or analgesic administration must be assessed on an individual basis to address the pain and discomfort associated with hematomas and contusions.
- The sharing of knowledge and providing support to the patient and family cannot be minimized in the management of these complications.
From the Research
Definition and Difference
- A hematoma is a collection of blood outside of blood vessels, often caused by injury or trauma [(2,3)].
- A contusion, on the other hand, is a type of injury that occurs when blood vessels are damaged, causing blood to leak into the surrounding tissue [(2,4)].
Relationship Between Hematoma and Contusion
- A contusion can lead to the formation of a hematoma, as blood leaks into the tissue and collects [(2,4)].
- However, not all contusions result in a hematoma, and not all hematomas are caused by contusions [(4,3)].
Clinical Management
- The management of muscle hematomas, which can result from contusions, is an area of ongoing research, with few clinical trials providing evidence-based recommendations 4.
- In cases of acute compartment syndrome, which can be associated with hematoma and contusion, prompt diagnosis and treatment are crucial to prevent long-term damage [(2,5)].