From the Research
Conservative management of seromas is often the most appropriate initial approach, as it can lead to spontaneous resolution in many cases, as seen in a study where all cases of postoperative seromas after pediatric spinal deformity surgery resolved spontaneously without the need for operative management 1.
Management Options
Management options for a seroma include:
- Conservative management with observation, compression, and time for small, asymptomatic seromas
- Needle aspiration under sterile conditions for symptomatic or large seromas, potentially requiring multiple sessions if fluid reaccumulates
- Sclerotherapy using agents such as talc, tetracycline, or doxycycline to promote adhesion of the cavity walls for persistent seromas
- Surgical interventions like capsulectomy or placement of closed suction drains for recalcitrant cases that fail other treatments
Preventive Measures
Preventive measures include:
- Careful surgical technique with meticulous hemostasis
- Minimizing dead space with quilting sutures
- Appropriate postoperative compression
Importance of Management
Seromas form when serous fluid collects in potential spaces following surgery or trauma, often due to disruption of lymphatic channels and inflammatory processes, making management important to prevent complications like infection, delayed wound healing, or chronic pseudocyst formation 2, 3, 4, 5.
Recent Evidence
A recent study published in 2024 highlighted the importance of sac management in large inguinoscrotal hernia cases and discussed seromas after laparoscopic hernia repair, emphasizing the need for individualized management approaches 5.