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possible seroma
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possible seroma

Hi,
I had surgery about 3 months ago for a cubital tunnel release. The incision never really closed all the way, and about two weeks later my elbow became red, warm and puffy. The area where the incision didn't close properly was oozing a yellow substance, kind of sticky but with no foul odor. My surgeon took me back into surgery and did an Irrigation and Debridement. He did not culture the area. He closed me back up with sutures. This time it healed fine and everything was going great until about two weeks ago. My elbow started getting red and then became warm and puffy. My doctor said he thinks its a seroma or an effusion. He did not want to aspirate it. He put me in a splint and said that hopefully it will reabsorb. He did blood work and everything was normal, including my sed rate and wbc count.

My questions are:

1. How are seromas normally treated?

2. Does this sound like a seroma or effusion with my symptoms?

3. Should I seek a second opinion?

4. Should this be aspirated?

5. Why did this come back after almost two months?

I am facing a delimma because I am scheduled for neck surgery for a herniated disc. My neurosurgeon will not operate until my elbow is all better, with no redness or swelling. I am trying to figure out the best way to speed up the healing.

Thanks,

Debbie
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To answer your questions:

1) A seroma is a collection of fluid post-op.  Small seromas can be observed, however large collections should be drained, usually by opening up the wound.

2) You can consider an ultrasound to further determine what the fluid collection is.

3) I would certainly seek another opinion if you are not comfortable with the management.

4) Depending on the size of the fluid collection, draining should definitely be considered.

5) Considerations would be surgical technique or possible risk factors (i.e. obesity).  Another opinion should be sought to manage this issue.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b
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