what to do after a hematoma

[hm4295]

I was unlucky and developed a hematoma 2 days after my gyne surgery. After diagnosing it, my surgeon took me to the OR that same day and evacuated 450 cc. It's been 11 days since the evacuation and there is still some swelling and firmness. My surgeon says this is residual clotted material and that the uniform smooth contour of the firmness is a good thing. He says that I will have to be patient while it liquefies, and he will probably do some steroid injections eventually. The other side looks great, and my surgeon thinks the hematoma side will eventually catch up.

My questions:

-Is there anything I can do to help promote the liquefying? Or is this just a case where I have to be patient?

-Would fish oil possibly help? I know fish oil helps prevent clot formation, but I'm not sure if it does anything to existing clots. Naturally I will ask my surgeon before taking any.

Thanks!

[Litlriki]

Sorry to hear about your hematoma following surgery.  Your surgeon is correct--You need some patience and attentiveness, as on occasion, a seroma (fluid collection) may develop following hematoma.  I encourage massage in my patients, which helps with the swelling and contour as the hematoma resolves, and helps to break up scar tissue.  I'm not sure if there's any benefit to fish oil--I don't think it would help or hurt.  I normally recommend compression for 4 weeks after surgery, but in situations such as yours, I might recommend an extra 2 weeks of compression to help manage swelling.

Rick Silverman

[Dr. Elliot Jacobs]

Your surgeon did the absolute correct procedure -- ie drain the hematoma once it is recognized.  Usually, the blood from a hematoma will collect in the cavity between the skin and the underlying chest muscle.  But remember, blood can infiltrate adjoining tissues as well -- so in all likelihood, some of the surrounding tissues will be swollen and bruised.  There is nothing to do about that except to wait for the body to absorb the blood and for the swelling to subside.  Some massage and some continued compression can be of help -- but the most important thing is simply patience on your side -- just wait it out and you should do just fine.

Dr Jacobs

[hm4295]

At nearly 3 weeks post-op, is it okay to massage the indurated area on the side where the hematoma was? It is very firm and somewhat swollen in a 2 inch radius surrounding the areola, much like a very well defined pectoral muscle that's being flexed. I will also ask this question of my surgeon, but I'm curious what your suggestions would be.

Thanks for all your input!

[Litlriki]

You should check with your surgeon. You may have a small fluid collection that needs to be drained. 

RS

[DrPensler]

It sounds as though your care has been appropriate.It takes a while for the induration after a hematoma to resolve.I think an active lifestyle and massage help speed the resolution after a hematoma but you should follow your surgeons recommendations.