A seroma can form at an incision site after surgery. A seroma is a swelling resulting from the accumulation of fluid under the skin. It occurs when a dog is active immediately after surgery instead of remaining inactive during the post-surgery phase. This can become very serious, needing immediate attention by a veterinarian, who may have to drain the fluid. However, most often the body absorbs the fluid and the swelling diminishes.
Accumulation of Fluid
Seromas can occur anytime after surgery, causing puffiness, swelling and the accumulation of fluid around the incision area. This accumulated fluid is made of “serous fluid” or blood without most of the cells. Therefore it is usually watery with a slight blood color, but not as dark as blood itself.
Seromas are caused by the inflammation at the incision site. Normally, “drains” are placed below the incision to allow drainage of the wound. During the healing process, which can last from 7 to 10 days, careful monitoring is necessary.
Careful Monitoring
Sutures must be monitored throughout the recovery period. Depending upon the depth of the surgery and the type of the wound, the sutures can be multi-layered. The deepest layer closes deep tissues while the middle layer brings the lower layer of the skin together. The most exterior sutures bring the outer skin layer together and are the only visible layer of the wound. It is this layer that can become loose, especially if the dog chews at them.
An Elizabethan collar may be used to prevent a dog from having access to the sutures and either chew or lick them. Otherwise known as an E-collar, this flexible plastic lampshade device is secured around the dog’s neck and prevents him access from all parts of the body below the collar. However, he is still able to eat and drink. Licking and/or chewing can cause postoperative complications of infection and swelling.
During the recovery period, pay special attention to:
- Swelling (seromas) at the incision site
- Sutures that are missing or are falling out
- Discharge and/or bleeding from the incision
- Excessive chewing or licking of the sutures
- Any tissue protruding from the incision (wound dehiscence)
Complications
There are several complications that can prevent healing:
- Licking and/or chewing at the sutures can cause them to become loose or fall out, exposing the wound to infection.
- Formation of seromas due to the accumulation of fluids at the wound site, exposing the incision to infection or possible herniation of the tiss ues deep within the incision.
- Discharge at the incision site in the form of clear or slightly blood tinged fluid. This discharge should not be dripping nor should it be bloody.
- Tissues from the underlying skin layer should not protrude from the wound. This can lead to a fatal infection. Emergency treatment is usually necessary.
Treatment
Checking the wound site daily for any changes is extremely important. Any formation of seromas should be monitored and drained if deemed necessary by a veterinarian. Hydrogen peroxide wipes can clean up any fluid discharge and hot and cold therapy sessions can help reduce swelling. If the incision area is dirty or if there is a foul odor emitting from the wound, seek immediate medical attention.