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A seroma is a pocket of clear serous fluid that sometimes develops in the body after surgery. When small blood vessels are ruptured, blood plasma can seep out; inflammation caused by dying injured cells also contributes to the fluid.
Seromas can also sometimes be caused by injury, such as when the initial swelling from a blow or fall does not fully subside. The remaining serous fluid causes a seroma that the body usually gradually absorbs over time (often taking many days or weeks); however, a knot of calcified tissue sometimes remains.
Seromas are particularly common after breast surgery (for example after mastectomy), abdominal surgeries, and reconstructive surgery. They are a treatment target in partial-breast radiation therapy, The larger the surgical intervention, the more likely it is that seromas appear. Larger seromas take longer to resolve than small seromas, and are more likely to undergo secondary infection.
Seromas may persist for several months or even years, with the tissue surrounding the seroma hardening over time.
Seromas or lymphatic leaks (lymphoceles) may be difficult to manage at times. The removal of seromas by fine-needle aspiration is controversial: it is recommended by some for the reason that seromas can be a culture medium for bacteria, whereas others advise it only for excessive amounts of fluid collection because even an aspiration carried out under aseptic conditions carries a certain risk of infection. Depending on the volume and duration of leakage, control of a leak may take up to a few weeks to resolve with aspiration of serums and the application of pressure dressings. Manual Lymphatic Drainage (MLD) conducted by a trained professional can also assist in managing and treating seromas.
If a serum or leak does not resolve, for example after a soft tissue biopsy, it may be necessary to take the patient back to the operating room in order to place some form of closed suction drain into the wound. This usually is not necessary and conservative management prevails.
- Michael S. Sabel (23 April 2009). Essentials of Breast Surgery: A Volume in the Surgical Foundations Series. Elsevier Health Sciences. p. 177. ISBN 0-323-07464-2.
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- Department of Pathology University of Massachusetts Medical School (Emeritus) Guido Majno Professor; Department of Pathology University of Massachusetts Medical School (Emerita) Isabelle Joris Associate Professor (12 August 2004). Cells, Tissues, and Disease : Principles of General Pathology: Principles of General Pathology. Oxford University Press. p. 435. ISBN 978-0-19-974892-1.
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- Schwartz's principles of surgery: self assessment and board review, 8th edition, chapter 11, patient safety, errors, and complications in surgery
- A. Thomas Stavros (2004). Breast Ultrasound. Lippincott Williams & Wilkins. p. 393. ISBN 978-0-397-51624-7.
- M. A. Hayat (5 November 2008). Methods of Cancer Diagnosis, Therapy and Prognosis: Breast Carcinoma. Springer Science & Business Media. p. 562. ISBN 978-1-4020-8369-3.
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