From the Research
Management of a seroma complicating an anterior total hip replacement requires a stepwise approach based on severity, with the most recent and highest quality study suggesting that aspiration under sterile conditions and possible injection of a sclerosing agent like doxycycline may be effective in resolving the seroma 1.
Key Considerations
- For small, asymptomatic seromas, conservative management is recommended with observation, rest, compression garments, and regular monitoring.
- For larger or symptomatic seromas, aspiration under sterile conditions may be necessary, typically using an 18-gauge needle after local anesthetic administration.
- If the seroma recurs after 2-3 aspirations, more definitive treatment is warranted, which may include ultrasound-guided drainage with placement of a small drain for 24-48 hours, or surgical intervention with incision, drainage, and possible capsule excision.
Prophylactic Measures
- Meticulous surgical technique
- Careful hemostasis
- Consideration of closed-suction drains during initial surgery
- Appropriate postoperative compression
Monitoring for Infection
- Increasing pain
- Redness
- Warmth
- Fever
- Immediate evaluation for possible infected hematoma or deep infection is necessary if signs of infection are present.
Recent Study Findings
- A 2021 study published in BMJ case reports found that aspiration and injection of doxycycline was effective in resolving a seroma complicating a total hip replacement 1.
- Another study published in 2020 found that vacuum-assisted closure therapy was effective in managing chronic seromas 2.
- However, the most recent and highest quality study 1 suggests that aspiration and injection of a sclerosing agent may be a more effective treatment option for seromas complicating anterior total hip replacement.