Papanikolaou Athanasios, Minger Eliane, Pais Michael-Alexander, Constantinescu Mihai, Olariu Radu, Grobbelaar Adriaan, Lese Ioana
Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, 3008 Bern, Switzerland.
Department for BioMedical Research, University of Bern, 3008 Bern, Switzerland.
J Clin Med. 2022 Aug 28;11(17):5062. doi: 10.3390/jcm11175062.
Introduction: Seroma formation is a serious postoperative complication. Since the management algorithms available in the literature are scarce, we aimed to analyze our experience with postoperative seroma in order to identify indicators for revisional surgery and propose recommendations for management. Methods: This retrospective study included all patients with postoperative seroma treated in a tertiary university hospital from 2008 to 2020. Patients’ demographics, medical history, and seroma treatment details were recorded and analyzed. Results: Overall, 156 patients were included: 41% were initially treated through needle aspiration, with 61% eventually undergoing surgical treatment for postoperative seroma. Comorbidities, such as heart failure and coronary heart disease, were significantly associated with an increased need for revisional surgery (p < 0.05). Both a duration of >40 days of repeated needle aspirations and drain re-insertions were significantly correlated with an increased risk for revisional surgery (p < 0.05). Conclusion: Patients requiring seroma aspiration should be counseled on surgical treatment sooner rather than later, as prolonged aspiration time (over 40 days) greatly increases the risk of surgical revision. Moreover, the reinsertion of a drain should only be used as a temporizing measure, at most, and patients requiring a drain to control the size of the seroma should promptly be scheduled for a surgical revision.
血清肿形成是一种严重的术后并发症。由于文献中可用的管理算法稀缺，我们旨在分析我们在术后血清肿方面的经验，以确定再次手术的指标并提出管理建议。方法：这项回顾性研究纳入了2008年至2020年在一家三级大学医院接受治疗的所有术后血清肿患者。记录并分析了患者的人口统计学、病史和血清肿治疗细节。结果：总体而言，纳入了156例患者：41%最初通过针吸治疗，61%最终因术后血清肿接受手术治疗。心力衰竭和冠心病等合并症与再次手术需求增加显著相关（p<0.05）。重复针吸和引流重新插入持续时间>40天均与再次手术风险增加显著相关（p<0.05）。结论：对于需要进行血清肿抽吸的患者，应尽早建议其接受手术治疗，因为抽吸时间延长（超过40天）会大大增加再次手术的风险。此外，引流重新插入最多只能用作临时措施，对于需要引流以控制血清肿大小的患者，应及时安排再次手术。
