From the Guidelines
Yes, hematomas can become infected, though this is relatively uncommon. When a hematoma (a collection of blood outside blood vessels) becomes infected, it's called an infected hematoma or abscess. This typically occurs when bacteria enter the hematoma through breaks in the skin, during surgery, or via bloodstream. Signs of an infected hematoma include:
- Increased pain
- Redness
- Warmth
- Swelling
- Pus drainage
- Fever
- General malaise Treatment usually involves antibiotics such as cephalexin 500mg four times daily for 7-10 days for mild cases, or stronger intravenous antibiotics for severe infections 1. Larger infected hematomas often require surgical drainage. People with compromised immune systems, diabetes, or poor circulation face higher infection risks. To prevent infection, keep any injury clean, follow wound care instructions, and seek medical attention if you notice signs of infection. Prompt treatment is essential as infected hematomas can lead to serious complications like sepsis if left untreated. Prevention of hematoma during procedures is desirable, and several interventions have been used, including meticulous cautery of bleeding sites and consideration of packing the pocket with antibiotic-soaked sponges to provide tamponade while leads are being placed 1. A hematoma should be evacuated only when there is increased tension on the skin, and needle aspiration should otherwise be avoided because of the risk of introducing skin flora into the pocket and subsequent development of infection 1. In immunosuppressed patients, empiric courses of broad-spectrum antibiotics should be commenced while waiting for cultures, and infection may be managed without removal of the catheter in some cases 1. The involved catheter should be removed in all cases of septic thrombosis, and incision and drainage and excision of the infected peripheral vein and any involved tributaries should be done, especially when there is suppuration, persistent bacteremia or fungemia, or metastatic infection, in conjunction with appropriate antibiotic therapy 1.
From the Research
Infection Risk in Hematomas
- Hematomas can become infected, although the provided studies do not directly address this topic, they discuss infection risks and prevention strategies in various medical contexts 2, 3, 4, 5, 6.
Related Infection Risks
- Surgical site infections are a significant concern in many medical procedures, and antibiotics like cefazolin, ceftriaxone, and vancomycin are used to prevent them 2, 3, 4, 5, 6.
- The risk of infection is higher in certain types of injuries, such as grade 3 open fractures, where the skin and soft tissues are compromised 2.
Antibiotic Use and Infection Prevention
- Cefazolin is a commonly used antibiotic for surgical prophylaxis, and its effectiveness has been compared to other antibiotics like ceftriaxone and vancomycin in various studies 3, 4, 5, 6.
- The use of cefazolin in patients with a beta-lactam allergy has been evaluated, and it appears to be safe and effective in preventing surgical site infections 4, 6.