Seroma usually occurs after 3 to 4 weeks and disappears in most cases by 2 months. Do early post-op pressure dressings reduce in any way subsequent seroma formation? Could pressure dressings help in obliteration of any dead space quite early and henceforth prevent a seroma?
Hi Dr Jameel,
A similar discussion can be seen at:
https://www.researchgate.net/post/How_do_you_manage_fluid_collection_build-up_in_the_space_left_after_laparoscopic_hernia_repair
regards, raza
No, because the properitoneal space is practically not affected by external pressure. It may be useful for preventing seromas after supra-muscular dissection, but vanishes under the muscle.
I assume only gentle and cautious dissection of the properitoneal space may reduce seroma formation.
I supposed pressure replaces any laparoscopy residual carbon dioxide accumulation for some time in that space. We used pressure dressing in lap TAPP...... But not in open surgery.
I agree with you all. The only thing why can external pressure be helpful is that some patients are worried about the lump that was a hernia before the operation despite preoperative consultations and explanations. External compression for several days could minimize the lump shifting the fluid in the intraperitoneal direction. But I agree that this technique could not eliminate fluid accumulation.
If scrotal seroma were coming from the abdomen wall dissection trauma, a pressure dressing might help, but as I believe it is due to the surgical trauma of the dissection of the hernia sac, there would be no practical way to apply pressure to the scrotum, short of an astronaut's space suit. Sorry, my long winded version of "no"
Seroma formation is a gradual process.Early compression not only won,t resolve the problem but also will add the local pressure complications.
With regards;
Definitely sharp and gentle dissection, with good hemostasis have key role in preventing seroma formation, pressure bandage also help in reducing space
Seroma formed as reactions to trauma and foreign body - mesh. The seroma consisting of leukocytes, erythrocytes, macrophages, mast cells, blood serum from damaged venous and lymphatic capillaries. Compression wound from one side will not stop chylorrhea and reaction to mesh. Therefore, no sense of pressure dressings after laparoscopic hernia repair.
Compression does not prevent seroma but COULD POTENTIALLY minimize hematoma
I think the optimists must be using MAST pants for compression to achieve anything. Any less extensive compression would simply shift fluid from one area to a neighboring one.
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