A surgical hematoma is a collection of blood in a sac in close proximity to a surgical site. This complication of surgery can occur in many different locations and usually resolves on its own, although in some cases, the surgical site needs to be reopened to allow a surgeon to drain the hematoma and fix the cause. There are a number of potential causes for hematomas after surgery, including the use of blood thinners before surgery, poor surgical technique, and inadequate aftercare. People can reduce their risks by following directions from the surgeon to the letter after surgery.
In a surgical hematoma, bleeding below the skin leads to the formation of a pouch of blood. This can happen when a surgeon doesn't completely seal off blood vessels, when a patient strains and pops a blood vessel, or as a result of thin, friable blood vessels around the site. The surgical site may swell, and patients can also see discoloration under the skin caused by the balloon of blood.
Surgical hematomas often reabsorb. Over time, the blood will break down and be carried away, although the patient can experience some discomfort during the early healing stages. In other patients, when it is evident the hematoma is large or painful, drainage may be recommended. Simple needle aspiration can be used to quickly pull blood out of the surgical hematoma, but it often refills. In surgery, a doctor can open up the hematoma, express the blood, and find the leaking blood vessel causing the problem.
Before surgery, people are usually advised to avoid blood thinners to minimize the risk of severe blood loss during surgery and prevent post-surgical hematoma. Surgeons may ask patients to wait to go back on these medications until the initial danger phase of healing is over. To avoid hematomas during surgery, surgeons take steps like carefully sealing off vessels and waiting before closing the incision. After surgery, avoiding physical strain and blows to the surgical site are recommended to prevent surgical hematoma.
If a hematoma develops, the surgeon will want to examine the patient to decide on the best treatment option. Some patients are sent home and told to watch the swelling, while others may be advised to go to surgery for drainage and correction. People who are frustrated with hematomas should not attempt to drain them at home, as this can introduce the risks of infection, uncontrolled bleeding, and disfiguring scars.