Lymph node biopsy post op

[garagegirl]

I had surgery to remove a swollen inguinal node and one in my axillary region.  All of the pathology came back negative.  However, at the inguinal site, a large lump or hematoma has arisen.  It is the size of a large olive under the incision site.  I saw my surgeon yesterday and he said it "should" subside.  He suggested heat compress.  I did that last night and it seems the lump has almost enlarged.  How long does it take for this type of swelling to subside?  The lump is very uncomfortable.  Should it be "drained"?  When is this considered a problem?

[garagegirl]

Thank you for your input.  This thing is driving me crazy and hurts.  My surgery was one week ago yesterday.  Should I still start with the cold compress?  Is walking around doing normal activities more helpful or should I take it easy and stay off my feet?  
Thanks :)

[Fernando Roque, MD]

Hi.  I think the proper way of preventing the further enlargement of your hematoma is to apply cold compress initially (about one or two days). Applying warm compress at the onset would tend to dilate blood vessels and increase the bleeding underneath the skin, resulting in a larger hematoma.  Cold compress would facilitate any pooled blood and severed blood vessels to clot.  Once the blood is sufficiently clotted and no further bleeding is noted, you can then switch to warm compress, to mobilize the clotted blood.  If there is rapid enlargement of the hematoma, it may mean that there is active bleeding inside the lump.