- Cause : space created between tissue planes in a surgical or traumatic wound. Commonly seen in high-motion areas.
- Signs : nonpainful, fluid-filled swelling beneath the skin.
- Diagnosis : signs, history, +/- aspiration.
- Treatment : conservative, occasionally drainage is required.
- Prognosis : generally excellent, usually resolves spontaneously.
- Soft swelling beneath the skin, near a recent surgery or trauma. More likely to appear in surgical wounds over high-motion areas, eg shoulder.
- Usually in the subcutaneous layer, but may be between muscle layers.
- Generally no systemic illness, no lameness, no pain on palpation.
- May be secondarily infected → erythema and discharge.
- Abscess : likely if it has already been aspirated, or there was gross contamination at the time of surgery. May see signs of local inflammation or signs of systemic illness. Aspirate for bacteria or inflammatory cells.
- Incisional hernia : possible if the surgical site is over the abdomen. Palpate the integrity of the body wall. Aspirate for fat or bowel contents.
- Neoplasia : unlikely due to the acute onset and rapid expansion in size, and correlation with a recent trauma or surgery. Aspirate for neoplastic cells.
- Excellent in most cases.
Expected response to treatment
- Conservative treatment (compressive bandage and restricted activity) should result in resolution of the seroma within several weeks.
- Surgically aspirated seromas may recur and aspiration can be repeated. Every time a seroma is aspirated, strict aseptic technique should be used to avoid causing an infection. A compressive bandage may prevent recurrence.
- Surgically drained seromas will continue to drain for several days. When the drainage diminishes, the drain may be removed. A compressive bandage may be needed for several more days to prevent recurrence.
Reasons for treatment failure
- Infection is a potential sequela to aspiration or surgical drainage. This occurs if the procedures are not done aseptically or if the drain site is not kept covered with a bandage.
- Failure to restrict activity will result in prolonged resolution of signs.