From the Guidelines
A hematoma located superficially above the right gluteal muscles typically resolves within 2-4 weeks, though this timeline can vary based on the size and severity of the injury. The resolution time can be influenced by various factors including the depth and size of the hematoma, as well as the overall health of the individual 1. It's essential to note that while the provided evidence primarily discusses surgical site infections and their management, the principles of wound healing and the body's response to injury can be applied to hematomas as well.
Factors Influencing Resolution Time
- Size of the hematoma: Larger hematomas may take longer to resolve, potentially requiring 4-6 weeks or more for complete absorption.
- Severity of the injury: More severe injuries may lead to larger hematomas or complications that prolong the healing process.
- Depth of the hematoma: Hematomas located closer to the surface of the skin may resolve faster than those located deeper in the tissue.
Management and Care
To facilitate the healing process and reduce discomfort, the following steps can be taken:
- Apply ice for the first 24-48 hours (20 minutes on, 20 minutes off) to reduce swelling and pain.
- Switch to warm compresses after 48 hours to increase blood flow and aid in the absorption of the hematoma.
- Use over-the-counter pain relievers like acetaminophen (Tylenol) at 650mg every 6 hours as needed to manage pain.
- Rest the area initially and gradually return to normal activities to avoid exacerbating the injury.
When to Seek Medical Evaluation
If the hematoma is large, painful, continues to grow, or doesn't improve after 2 weeks, medical evaluation is recommended as some cases may require drainage or other interventions 1. It's crucial to monitor the hematoma's progression and seek medical attention if any signs of infection or complications arise.
From the Research
Resolution Time for Hematoma
- The resolution time for a hematoma located superficial to the upper margin of the right gluteal musculature is not directly addressed in the provided studies.
- However, a study on chronic expanding hematoma extending over multiple gluteal muscles associated with piriformis syndrome 2 reported a case where a patient had a 6-year history of an enlarging mass of the left buttock, which was eventually surgically removed and did not recur after 4 years.
- Another study on ultrasound of musculoskeletal hematomas 3 found that the sonographic appearance of a hematoma is unrelated to its age, and that ultrasound-guided aspiration of hematomas is a safe and effective procedure.
- A literature review on the physiotherapy management of muscle haematomas 4 concluded that few clinical trials have been published assessing the efficacy of physiotherapy strategies for treating muscle haematomas, and that further study is recommended to identify the best therapeutic interventions.
- A case report on injection-related bleeding from the gluteus superior artery 5 described a patient who developed a hematoma, abscess, and systemic inflammatory response syndrome after a dorso-gluteal injection, and was treated with drainage and antibiotic therapy, with complete recovery after 2 months.
Factors Affecting Resolution Time
- The size and location of the hematoma may affect its resolution time, as well as the presence of any underlying conditions or complications, such as infection or nerve damage 2, 5.
- The effectiveness of treatment, including physiotherapy and ultrasound-guided aspiration, may also impact the resolution time of the hematoma 3, 4.