Forum Discussion

Isaidso's avatar
Isaidso
Member
8 years ago

How to manage seroma post mastectomy?

I had mastectomy surgery on 2 August  and am seeking advice on how to manage a seroma. 
I had a poor experience after my last mastectomy surgery-staph infection, seroma drained by hand in ward, it was a traumatic experience and thus my concern about seroma and how to manage??
My surgeon doesn't use drains. any advice would be very much appreciated. Thanks Terrie 

7 Replies

  • I can sympathise Isaidso, my seroma lasted nearly a year, and I ended up with a serious infection, a week in hospital and surgery to finally clean everything out (which worked, hooray). Aspirations indicated no infection for a long time, but the fluid kept coming back. 
  • Thanks very much for your responses.
    @TonyaM - My surgeon doesn't use drains post op, nor it seems is keen to drain in the weeks after surgery? 
    @Zoffiel It was late one night in the ward that the seroma was aspirated-sutures where snipped and the fluid drained from my hazy memory 250 mls. A traumatic experience! I 
    Short story - I had developed sepsis, later that night my blood pressure was so low emergency doctors were called, my kidneys failed. I was discharged after 6 nights, it slowed my recovery significantly. 
    So I have this fear of seroma and infection!!
    @Afraser I will look to massage and fingers crossed it disperses naturally.
    @Amazonia I am seeing my surgeon next Thursday so will ask about compression and if there's anything I can do.  
  • I had a seroma on my chest scar for 5 weeks. My surgeon drained it twice a week and it gradually settled down.It depends on how big and where as to whether it needs draining.
  • Eeek, no! Pathology is the place for draining, mercifully no-one even suggested draining mine anywhere else. Apart from anything else there should be a test with the drained fluid to check for infection. Problem with a seroma, especially if it lingers, is that it can become an infection site without any external cause - your own body normally keeps bad bacteria under control, but with external forces such as chemo, your immune system can take a battering. Your body is working overtime to heal, so the fluid is nutrient rich. Great for a wound, terrific for bugs too! 
  • Seroma are a trial, they really are. If you do end up in the unfortunate position of having another, try to get it drained in the pathology or radiography unit if you can. I had a situation where someone 'Stuck a pin in it' in a ward. Never again. 
    Seroma may be a dime a dozen, but they are not to be taken lightly.
  • HI there,
    Ive not heard of a surgeon not using drains.  Regardless, for my first mastectomy, I had two drains which took 8 days before fluid output was reduced enough for my Plastic Surgeon to allow me to go home.
    I developed a large Seroma in the breast space which also contained a tissue expander only mildly inflated with 100 mls in the week I was home. This was drained weekly of 500 mls ! for 4 weeks and very uncomfortable, filling and sloshing around. Unfortunately, combined with the start of chemo and plummeting immunity this led to an infection and hospitalisation with the removal of the expander.
    My PS was devastated and I was disappointed but with some serious compression after this surgery, it did not return.
    After chemo finished I had the second mastectomy and bilateral expanders inserted.
    My PS was determined we would do everything to ensure the Seroma didn't return.
    He filled both expanders with 350 miles during the surgery to limit the breast space and I wore a fabulous thick, tight compression crop top provided by him for the next 6 weeks.
    Happy to say this worked for me.
    Perhaps ask your surgeon about compression. They are all different in their approach and management but it was very effective for me.
    Best of luck .
    A.
  • I wish I had tried massage earlier. I had a persistent seroma, and infections (which may be caused by the bacteria you have naturally in your body, not just draining the seroma). A good lymphoedema therapist may be able to help disperse the fluid gently and stop it refilling. Mind you, it's still early days yet, best to wait and see if it disperses naturally first. Good luck.