Yellow liquid from the seam. Seroma: why it develops, and how to eliminate it without consequences

Almost every person has experienced the appearance of ichorus. What to do if a clear liquid flows out of the wound? Its occurrence indicates that the integrity of the tissue has been violated: a person has cut himself or been injured.

The ichor is a colorless liquid that flows from the wound. After some time, the ichor turns into a film and tightens the wound. Thus, the wound is protected from getting into it of various infections.

The medical name for the ichorus is lymph. There are no erythrocytes in the lymph, but there are a huge number of lymphocytes. Mostly lymph is secreted from small wounds. Its movement is from top to bottom. When a person is injured, not a large number of lymph or not.

The human body can contain from one to two liters of lymph. The lymphatic fluid is cleared in the nodes of the same name. Nodes are located at the junction of several vessels into one.

However, ichor is not only a colorless liquid. A similar name may mean bloody discharge from a wound or purulent discharge. Purulent discharge say that the wound is infectious. The discharge of pus helps the wound to clear faster. During this period, it is important to provide the wound with proper care so that bacteria do not get there. Isolation of ichor is also possible from drainage wounds.

The appearance of ichor is the norm, if, of course, it is colorless. Its appearance suggests that the immune system of the human body is functioning correctly and is ready to protect the body from infection at any time. Also, the appearance of a colorless liquid characterizes the normal functioning of blood vessels. If lymph is secreted from the wound, then the vessels are not damaged.

There are several varieties of ichor:

1. Gynecological discharge. A woman can notice such discharge immediately after the end of menstruation, during gestation and during the onset of menopause. If the discharge appears in small quantities, then this does not pose any danger to the woman.
2. Discharge of ichor from the nose. Discharges from respiratory tract also called the sacrum. Their cause is the development of inflammatory processes and the appearance of viral diseases. The ichor can be either yellow or transparent, or bloody. Allocations include a number of other symptoms that characterize the onset of the inflammatory process in the body.

From what wounds does the ichor come out?

It is known that ichor flows not only from recently received wounds. For example, colorless discharge can also appear in newborns in the navel area. This is a sign of healing of the umbilical region. If a purulent liquid with a specific smell begins to stand out from the navel, the baby's parents should show it to the doctor as soon as possible. An antibiotic ointment or some other type of treatment may be prescribed to treat a purulent ichorus.

The clear fluid released from the umbilical region in a newborn requires special care than the discharge of such fluid in older people. However, care should not necessarily be provided by the staff of the children's clinic or pediatrician. The parents of the baby will be able to cope with the procedure on their own, without outside help.

Thorough disinfection of the area of ​​fluid release is necessary.

It must be carried out several times a day, especially after changing the diaper to a new one, as well as after water procedures which are usually held in evening time. As a means for drying the wound, it is recommended to use not hydrogen peroxide, but ordinary brilliant green, which is commercially available in any pharmacy in the city.

It is important to ensure that moisture does not get into the umbilical ring area. This can negatively affect the healing of the wound: it will be delayed longer than it should be.

The ichor can also stand out in the elderly. This happens after surgery. The place of isolation of the ichor is the scars left after the operation. In people aged 30-40 years, this phenomenon is extremely rare.

Allocations accompany the healing of the suture after surgery caesarean section. Disinfection measures are similar to caring for the umbilical region in a newborn. Such secretions will accompany the woman while she is under the care of medical staff in the maternity home. Therefore, she is unlikely to have to worry about how to care for the wound on her own. All the necessary disinfection procedures fall on the shoulders of the medical staff and employees of the maternity hospital, who will provide the young mother with complete care.

Such appearances of ichorus are absolutely harmless. However, it is important to ensure that the wound does not become inflamed.

Ways to deal with the release of ichor from wounds

The icing does not have to be removed at all. Gradually, the discharge from the wound will stop on its own, without the participation of the owner of the wound in this process.

If lymph secretion is accompanied by unpleasant sensations or the appearance of discomfort, the wound should be treated with hydrogen peroxide. Read the instructions carefully before using hydrogen peroxide. It should indicate whether it is necessary to dilute the peroxide with water before use. If you use the drug without first studying the instructions, you can get a severe burn, due to which the wound will become even more inflamed.

The wound is treated with a cotton swab or bandage. In no case should peroxide be poured into the wound from the bottle into which it is poured, or a bandage or cotton swab soaked in liquid should be applied for a long time.

Alternatively, streptocide may be used. It is sold in pharmacies in the form of tablets. Before using the tablet, it is necessary to crush it to a powder state, using a kitchen board and a knife for this, and sprinkle it on the wound. You can also use sea ​​buckthorn oil or greenery.

Absolutely any drugs that have a drying and healing property can be used as methods of dealing with ichorism.

If self-treatment of the wound does not help, you should take the help of a qualified medical professional. He will treat the wound with specialized medicines, which cannot be purchased independently without a doctor's prescription.

Can be used to heal a wound special ointments. Adults are prescribed "Levomekol" - an ointment that promotes not only the rapid healing of wounds, but also the passage of edema after burns. Children are recommended to smear wounds with Panthenol.

The main task is to protect the wound from possible infection. In order to prevent this from happening, all precautions should be taken by sticking a sterile bandage on the wound.

As soon as the ichor ceases to appear, care must be taken not to accidentally tear off the crust that appeared instead of it on the wound. The crust performs a function similar to that of lymph - it protects the wound from pathogenic microbes entering it. If the crust is nevertheless torn off, a scar may subsequently appear at the site of the wound.

What to do in case of abundant lymph flow?

If there is a lot of lymph flow, bandaging the wound with an elastic bandage can help.

If the presented methods of dealing with abundant lymph leakage do not bring any result, you should immediately contact medical institution for qualified assistance. Other effective measures just doesn't exist. Be healthy!

Any surgical intervention is a great test for the patient's body. This is due to the fact that all its organs and systems experience increased load It doesn't matter if the operation is small or large. Especially "gets" the skin, blood, and if the operation is performed under anesthesia, then the heart. Sometimes, after everything seems to be over, a person is diagnosed with a “seroma of the postoperative suture”. What it is, most patients do not know, so many are afraid of unfamiliar terms. In fact, seroma is not as dangerous as, for example, sepsis, although it also does not bring anything good with it. Consider how it turns out, what is dangerous and how it should be treated.

What is it - postoperative suture seroma

We all know that many surgeons perform “miracles” in the operating room, literally bringing a person back from the other world. But, unfortunately, not all doctors conscientiously perform their actions during the operation. There are cases when they forget cotton swabs in the patient's body, do not fully ensure sterility. As a result, in the operated person, the suture becomes inflamed, begins to fester or diverge.

However, there are situations when problems with a suture have nothing to do with the negligence of doctors. That is, even if 100% sterility is observed during the operation, the patient in the incision area suddenly accumulates a liquid that looks like an ichor, or pus of a not very thick consistency. In such cases, one speaks of a seroma of the postoperative suture. What it is, in a nutshell, we can say this: it is the formation of a cavity in the subcutaneous tissue in which serous effusion accumulates. Its consistency can vary from liquid to viscous, the color is usually straw yellow, sometimes supplemented with blood streaks.

At-risk groups

Theoretically, a seroma can occur after any violation of the integrity of the lymphatic vessels, which do not “know how” to quickly thrombose, as blood vessels do. While they are healing, lymph moves through them for some time, flowing from the places of ruptures into the resulting cavity. According to the ICD 10 classification system, the seroma of the postoperative suture does not have a separate code. It is put down depending on the type of operation performed and on the cause that influenced the development of this complication. In practice, it most often happens after such cardinal surgical interventions:

• abdominal plastic;
• caesarean section (for this seroma of the postoperative suture, ICD code 10 “O 86.0”, which means suppuration of the postoperative wound and / or infiltrate in its area);
• mastectomy.

As you can see, the risk group is mainly women, and those of them who have solid subcutaneous body fat. Why is that? Because these deposits, when their integral structure is damaged, tend to flake off from the muscle layer. As a result, subcutaneous cavities are formed, in which fluid begins to collect from the lymphatic vessels torn during the operation.

The following patients are also at risk:

• suffering from diabetes;
• aged people (especially overweight);
• hypertension.

Causes

To better understand what it is - postoperative suture seroma, you need to know why it is formed. The main causes do not depend on the competence of the surgeon, but are a consequence of the body's reaction to surgical intervention. Those reasons are:

1. Fat deposits. This has already been mentioned, but we add that in overly obese people whose body fat is 50 mm or more, seroma appears in almost 100% of cases. Therefore, doctors, if the patient has time, recommend performing liposuction before the main operation.
2. Large area of ​​the wound surface. In such cases, too many lymphatic vessels are damaged, which, accordingly, release a lot of fluid, and heal longer.

Increased tissue trauma

It was mentioned above that the seroma of the postoperative suture depends little on the conscientiousness of the surgeon. But this complication directly depends on the skills of the surgeon and the quality of his surgical instruments. The reason why a seroma can occur is very simple: the work with tissues was too traumatic.

What does it mean? An experienced surgeon, performing an operation, works delicately with damaged tissues, does not squeeze them unnecessarily with tweezers or clamps, does not lack, does not twist, the incision is made quickly, in one precise movement. Of course, such jewelry work largely depends on the quality of the instrument. An inexperienced surgeon can create the so-called vinaigrette effect on the wound surface, which unnecessarily injures the tissues. In such cases, the postoperative suture seroma code ICD 10 can be assigned as follows: "T 80". This means "a complication of surgery not noted elsewhere in the classification system."

Excessive electrocoagulation

This is another reason that causes a gray suture after surgery and to some extent depends on the competence of the doctor. What is coagulation in medical practice? This is a surgical intervention not with a classic scalpel, but with a special coagulator that produces a high-frequency electric current. In fact, this is a point cauterization of blood vessels and / or cells with a current. Coagulation is most often used in cosmetology. She excels in surgery as well. But if it is performed by a physician without experience, he may incorrectly calculate the required amount of current strength or burn excess tissue with them. In this case, they undergo necrosis, and neighboring tissues become inflamed with the formation of exudate. In these cases, the seroma of the postoperative suture in ICD 10 is also assigned the code "T 80", but in practice such complications are recorded very rarely.

Clinical manifestations of seroma of small sutures

If the surgical intervention was on a small area of ​​\u200b\u200bthe skin, and the suture turned out to be small (respectively, the traumatic manipulations of the doctor affected a small amount of tissue), the seroma, as a rule, does not manifest itself in any way. In medical practice, there are cases when patients did not even suspect about it, but such a formation was discovered during instrumental studies. Only in isolated cases does a small seroma cause slight pain.

How to treat it and should it be done? The decision is made by the attending physician. If he deems it necessary, he can prescribe anti-inflammatory and pain medications. Also, for a faster doctor may prescribe a number of physiotherapy procedures.

Clinical manifestations of seroma of large sutures

If the surgical intervention affected a large volume of the patient's tissues or the suture turned out to be too large (the wound surface is extensive), the occurrence of seroma in patients is accompanied by a number of unpleasant sensations:

• redness of the skin in the area of ​​the seam;
• pulling pains, aggravated in the standing position;
• during operations in the abdominal region, pain in the lower abdomen;
• swelling, bulging of the abdomen;
• temperature increase.

In addition, suppuration of both large and small seroma of the postoperative suture may occur. Treatment in such cases is carried out very seriously, up to surgical intervention.

Diagnostics

We have already examined why a seroma of a postoperative suture may occur and what it is. The methods of treating seroma, which we will discuss below, largely depend on the stage of its development. In order not to start the process, this complication must be detected in time, which is especially important if it does not declare itself in any way. Diagnostics is carried out by such methods:

Examination by the attending physician. After the operation, the doctor is obliged to examine the wound of his patient daily. If undesirable skin reactions (redness, swelling, suppuration of the suture) are detected, palpation is performed. If there is a seroma, the doctor should feel fluctuation (flow of liquid substrate) under the fingers.

ultrasound. This analysis perfectly shows whether or not there is fluid accumulation in the seam area.

In rare cases, a puncture is taken from the seroma to clarify the qualitative composition of the exudate and decide on further actions.

Conservative treatment

This type of therapy is practiced most often. In this case, patients are assigned:

• antibiotics (to prevent possible further suppuration);
• anti-inflammatory drugs (they relieve inflammation of the skin around the seam and reduce the amount of fluid released into the resulting subcutaneous cavity).

More often appointed nonsteroidal drugs such as Naproxen, Ketoprofen, Meloxicam.

In some cases, the doctor may prescribe anti-inflammatory steroids, such as Kenalog, Diprospan, which block inflammation as much as possible and accelerate healing.

Surgery

According to the indications, including the size of the seroma and the nature of its manifestation, surgical treatment can be prescribed. It includes:

1. Punctures. In this case, the doctor removes the contents of the resulting cavity with a syringe. Positive sides such manipulations are as follows:

• can be performed on an outpatient basis;
• painless procedure.

The disadvantage is that you will have to do a puncture more than once, and not even two, but up to 7 times. In some cases, it is necessary to perform up to 15 punctures before the tissue structure is restored.

2. Installation of drainage. This method is used for seromas that are too large in size. When setting up a drain, patients are given antibiotics in parallel.

Folk remedies

It is important to know that regardless of the reasons for which the seroma of the postoperative suture arose, the treatment of this complication with folk remedies is not carried out.

But at home, you can perform a number of actions that promote the healing of the seam and are the prevention of suppuration. These include:

• lubrication of the seam with antiseptic agents that do not contain alcohol ("Fukortsin", "Betadine");
• application of ointments ("Levosin", "Vulnuzan", "Kontraktubeks" and others);
• inclusion in the diet of vitamins.

If suppuration has appeared in the seam area, it is necessary to treat it with antiseptic and alcohol-containing agents, for example, iodine. In addition, antibiotics and anti-inflammatory drugs are prescribed in these cases.

Traditional medicine, in order to speed up the healing of the seams, recommends making compresses with an alcohol tincture of livestock. Only the roots of this herb are suitable for its preparation. They are well washed from the ground, crushed in a meat grinder, put in a jar and poured with vodka. The tincture is ready for use in 15 days. For a compress, you need to dilute it with water 1: 1 so that the skin does not burn.

For wound healing and surgery there are many folk remedies. Among them are sea buckthorn oil, rosehip oil, mummy, beeswax, melted together with olive oil. These funds must be applied to gauze and applied to the scar or seam.

Seroma of the postoperative suture after caesarean section

Complications in women who delivered by caesarean section are common. One of the reasons for this phenomenon is the body of a woman in labor, weakened by pregnancy, unable to provide rapid regeneration of damaged tissues. In addition to seroma, a ligature fistula or keloid scar may occur, and in the worst case, suppuration of the suture or sepsis. Seroma in women in labor after cesarean section is characterized by the fact that a small dense ball appears on the seam with exudate (lymph) inside. The reason for this is the damaged vessels at the incision site. As a rule, it does not cause anxiety. Seroma postoperative suture after cesarean does not require treatment.

The only thing a woman can do at home is to treat the scar with rosehip or sea buckthorn oil to heal it as soon as possible.

Complications

The seroma of the postoperative suture does not always and not all pass by itself. In many cases, without a course of therapy, it is able to fester. This complication can be caused chronic diseases(for example, tonsillitis or sinusitis), in which pathogenic microorganisms penetrate through the lymphatic vessels into the cavity formed after the operation. And the liquid that collects there is an ideal substrate for their reproduction.

Another unpleasant consequence of seroma, which was not paid attention to, is that it does not fuse with muscle tissue, that is, the cavity is always present. This leads to abnormal mobility of the skin, to tissue deformation. In such cases, it is necessary to apply repeated surgical intervention.

Prevention

On the part of the medical staff, preventive measures consist in the exact observance of the surgical rules for the operation. Doctors try to perform electrocoagulation sparingly, injuring tissues less.

On the part of patients, preventive measures should be as follows:

1. Do not agree to an operation (unless there is an urgent need for it) until the thickness of the subcutaneous fat reaches 50 mm or more. This means that first you need to do liposuction, and after 3 months to carry out the operation.
2. After surgery, wear high-quality compression stockings.
3. At least 3 weeks after the operation, exclude physical activity.

A seroma is a collection of fluid under the skin. Most often formed as by-effect from surgical intervention. The accumulation of serous fluid in some cases is also an incorrect or incomplete rehabilitation.

What is a seroma

A seroma is a collection of serous fluid at the intersection of capillaries. The accumulation of lymph usually occurs within the cavity, which is within the fatty tissue and aponeurosis of the human skin. That is why this symptom is the most common complication after surgery in overweight people.

The fluid accumulated in the cavity is an ideal habitat for pathogens. Therefore, with such a manifestation, it is necessary to eliminate the symptom. If you do not engage in adequate therapy in accordance with the patient's condition, then the risk of developing infectious disease rises many times.

Serous accumulation is generally a fairly common occurrence, which is easily eliminated by preventive measures in the form of drainage, weights in the area of ​​the seams, as well as compression underwear. With this exposure, the symptom usually resolves on its own and without complications. If you do not take therapeutic methods of exposure, then there is a risk of developing necrosis of the skin flap,.

It is also worth considering that due to seroma, the healing time of the sutures increases, and therefore the doctor will have to visit longer than originally planned.

Seroma opening postoperative scar shins after phlebectomy is shown in the video below:

Reasons for the appearance

There is a whole list of factors that affect the development of seroma after intervention in the body from the outside:

• Lymph capillaries;
• Inflammatory processes in the suture area;
• Overweight;
• Elderly age;
• Large volumes of the operation, in which a larger number of lymphatic connections are damaged;
• Individual reaction of the body to the intervention;
• Excessive tissue injury during the procedure;
• Squeezing of tissues during the operation;
• after operation;
• Excessive abuse of tissue coagulation;
• Lack of drainage;
• The reaction of the body to the suture material;
• Incorrect recovery period.

Accordingly, we can conclude that the formation of a seroma requires the intervention of a surgeon, and the greater this effect, the greater the seroma will be in the future. Most often develops after a mastectomy, (including),.

Seroma after mammoplasty (photo)

How to get rid of them

Getting rid of seromas is most often offered with the help of surgical or minimally invasive intervention, which depends on the stage of the pathology. There are also medication ways to stop and prevent the development of a symptom. The sooner the visit to the doctor occurs, the more optimistic the forecasts for therapy are.

At home

At home, you must do the following:

• With an unlaunched seroma, a strong infusion of thyme or chamomile, or herbs that also have an anti-inflammatory effect, is brewed.
• If this complication develops lower limbs, then you should put your foot on several pillows so that blood circulation in the tissues goes from bottom to top. Thus, puffiness is eliminated.
• Wearing tight compression underwear or wide elastic bandages.
• Imposition of a load weighing no more than 1 kg on the operating area. It can be a bag of salt or sand.

As a rule, compression underwear itself promotes the resorption of serous fluid in the cavity, exerting the necessary degree of pressure on the inflamed area.

It should also be understood that it is impossible to warm up the area of ​​​​impact, as this will only increase the chances of tissue infection.

Troubleshooting is shown in this video:

Care

Speaking about care, it should be understood that the intervention area can only be treated with antiseptics on its own, such as:

• Zelenki;
• Alcohol infusion;
• Yoda;
• Hydrogen peroxide;

Any means to choose from the list is taken and processed. After that, an antibacterial ointment is applied, if the situation requires it, and only then a sterile bandage.

quickly: it is not uncommon for a few days after the injury to continue to stand out from them transparent ichor, or lymph. Normally, lymph is involved in the cleansing of tissues from particles of dirt and dead cells. Consider in what cases it is necessary to stop its exudation.

Photo 1. With improper treatment, lymph turns into pus. Source: Flickr (jmawork).

Why is a clear liquid flowing from a wound?

When tissues of the body are damaged, exudation occurs at the site of injury: the vessels increase their throughput and fluid enters the intercellular space. So the body tries to get rid of foreign microorganisms. The watery ichor, having fulfilled its role, forms a protective film on the wound.

But sometimes the healing process is disrupted: for example, in the absence of an extensive damaged area, it becomes infected. Then the lymph continues to abundantly irrigate the wound.

Description of lymph

At the moment, the lymphatic system is one of the least studied structures. human body. It is believed that it is just an application to cardiovascular system. The functions of lymph are to nourish the tissues of the body, filtering out decay products, and transport lymphocytes..

Its structure includes vessels, nodes and organs (spleen, thymus behind the sternum and tonsils).

The lymphatic system performs its functions through the flow of lymph - a fluid that circulates freely in the body, and, if necessary, enters the intercellular space. Its content in the body is approximately 1-3 liters. Lymph moves from bottom to top at a speed of 5-16 cm / min.

She is consists of two fractions: lymphoplasm and shaped elements (lymphocytes, leukocytes). The composition of the plasma component includes proteins, electrolytes, enzymes, fats and sugars.

Lymph is usually a transparent substance, but milky white and yellowish coloration is also within the normal range.

How to distinguish pus from lymph

The formation of pus is associated with insufficient cleansing of the wound: dead protective cells (lymphocytes, neutrophils, macrophages, etc.) in the released ichor become a breeding ground for pathogenic microorganisms that inseminate the wound.

Note! Purulent inflammation indicates that the immune and lymphatic systems can not cope with the load that has arisen. Therefore, to avoid complications, antibiotics are prescribed for suppuration.

	Lymph	Pus
At what phase of healing does	phase of inflammation	phase of inflammation
Colour	Differs in transparency; color ranges from white (cream) to yellow	Turbid exudate dirty yellow, green, gray, blue (depending on the microbial composition)
Smell	Is absent	At the beginning of the selection is absent; over time - unpleasant putrid
Consistency	Watery, slightly viscous	Newly formed pus - liquid; gets thicker over time
Availability blood clots and vessels	Maybe	Maybe

What to do in case of excessive discharge

At proper care small scratches and abrasions disappear within a week without complications, and the ichor from the wound no longer stands out.

To speed up the regeneration process, the following measures should be taken:

• The use of drugs. A whole class is represented on the pharmaceutical market - creams ("Argosulfan" with silver", " Ambulance"), ointments ( ichthyol ointment, "Levomekol"), liniments (Vishnevsky's ointment). These drugs have a drying and antibacterial effect on the wound surface. And sorbent dressings ("Voskosorb") additionally increase the outflow of exudate.
• Wound isolation. Dressings that are applied after wound treatment will help to avoid re-microbial contamination. Apply dressings made of sterile breathable materials (gauze, cotton wool) and renew them at least twice a day.
• Diagnosis and treatment of chronic diseases. Some diseases provoke slow healing of wounds: for example, not only the processes of skin restoration slow down, but also its destructive changes intensify - there are trophic ulcers on foot.

Note! If you are worried about wounds after removing the stitches, you need to contact your doctor: he will assess the condition of the operated area, recommend wound care products and prescribe procedures to improve lymph outflow.

Do I need to stop the flow of lymph from the wound

Lymph flow from a wound is a natural defensive reaction of the body, therefore there is no need to stop its release in the inflammation phase(the first stage of wound healing, which lasts up to two days). During this period of time, enzymes and cells of the immune system destroy bacteria and fungi, and also stimulate the formation of new vascular bundles in the wound cavity.

Continuation of the release of the ichor 3-5 days after injury indicates the severity of the damage. In this case, it is required to stop the flow of lymph, so as not to stimulate its degeneration into pus. It is urgent to seek help from a medical institution (surgical department). You may need to drain the wound, debride it, and take antibiotics for a while.

Photo 2. If the wound does not heal for too long, antibiotics will be required.

A seroma is a collection of clear fluid that sometimes develops after breast surgery. Symptoms of a seroma include swelling in the operated area, sometimes with a clear or yellowish discharge through the scar. Sometimes it is accompanied by redness and mild pain or hypersensitivity. The seroma looks like a large lump or "bump".

If the fluid is not drained, it can lead to the formation of scarring hard tissue inside mammary gland.

Seroma common complication after surgical treatment of breast cancer and removal of fibroadenoma. Fluid in the mammary gland can also accumulate after any other mammoplasty, including:

• After breast reduction;
• Breast augmentation with implants;
• Mastectomies;
• Breast reconstruction operations;
• plastic surgery;
• Aesthetic reconstructive surgery;
• Gynecomastia;
• Seroma in the mammary glands is sometimes a consequence of radiation therapy;
• Any other operations in the chest area.

There is no definite time interval between the operation and the occurrence of seroma. There is also no clear definition of the possible factors leading to the accumulation of fluid in the chest. We can only assume the overall likelihood of seroma - the larger the operation, the higher the risk of occurrence.

Seroma can develop not only in the mammary gland, but also anywhere in the body due to trauma or surgery.

A seroma may be detected on breast imaging examinations, but this accumulation of fluid in the breast is usually very noticeable and easily palpable.

Seroma is completely unrelated to cancer cells and, in general, should not cause concern. But it can complicate and prolong the recovery postoperative period, so the fluid must be removed.

Seroma increases the risk of infection of the operated area, therefore, it requires mandatory monitoring and treatment.

How is a seroma formed?

Blood is essentially made up of a combination of serum (blood plasma, which is the liquid part of serum) and red blood cells. Sometimes red blood cells "settle", resulting in separation from the serum. And the serum accumulates in the "gray".

More often, a seroma is formed from a hematoma (hemorrhage), which is divided into blood clots and a yellow liquid (serum).

Sometimes a seroma is a leak of lymph from tissues. Most likely, this is due to the "leakage" of the capillaries. Perhaps during the operation, the tissues were severely compressed, and the endothelial cells lining the blood vessels became "sick" and could not withstand the leakage of serum from them.

Another reason is "leaky" blood vessels. If there is a tiny tear in a blood vessel or capillary, then serum can seep through it, but red blood cells cannot.

Dying or damaged cells can also cause an inflammatory process that contributes to the accumulation of serum fluid in the breast.

How painful is a seroma?

Sometimes the fluid buildup pulls on the surrounding tissue, stretching the nerve endings that send signals to the brain that the brain interprets as pain.

Seroma vs hematoma and abscess

A seroma is different from a mammary hematoma, which contains red blood cells; and from breast abscesses that contain pus. However, seroma is sometimes the result of a hematoma or seroma.

Aspiration of fluid from the chest with a thin syringe is a kind of definition - if the fluid is yellow, it is a seroma; if saturated red - hematoma. If the color is between yellow and red - you can consider it whatever you want.

Seroma treatment

To avoid the accumulation of fluid in the chest after surgery, the surgeon will leave the drainage tubes for a while and remove them when the fluid stops completely. However, a seroma can form after the drainage is removed.

Seroma is self-absorbed by the body, and most surgeons consider seroma an inevitable inconvenience, but not a serious complication.

However, the process can take many days or even weeks. Sometimes, after resorption of the seroma, a knot of calcified soft tissues may remain.

Calcified nodules may be visible on imaging breast examinations, but are not harmful to the body.

However, sometimes the accumulation of fluid in the breast is so excessive that it causes the skin to stretch and sag. Which causes discomfort to the patient and delays the recovery time after surgery. In these cases, fluid can be aspirated by fine needle aspiration, but in some cases, multiple approaches will be required.

If the seroma is so large that it threatens to diverge the edges of the surgical wound, the surgeon will insist on the introduction of drainage tubes, for which it is necessary to make an additional incision.

Both the seroma and the hematoma gradually resolve on their own without aspiration. And yes, tissues will recover faster if assisted by aspiration.

The seroma may "come back". But even if this happens, it will be much less.

How to prevent gray?

Direct light hand pressure on the operated area is a good prevention of fluid accumulation in the mammary gland after surgery. But you can not massage the scar or put pressure on it in different directions(at an angle), as this can lead to a divergence of the edge of the wounds.

for-breast.ru

Seroma after breast surgery

Every year more and more women turn to surgeons with a request to perform operations to increase or plastic change chest.

But not every representative of the weaker sex is aware of the possible appearance of seroma after breast surgery. As statistics show, seroma occurs in 15% of patients who underwent breast surgery.

Seroma is a complication caused by surgery, manifested by the accumulation of serous fluid. With this pathology, fluid accumulates inside the mammary gland, which stretches it. Women's breasts sag.

Development factors

Most often, the appearance of seroma is observed:

when using large implants in the case of plastic surgery;

when carrying out large operations accompanied by high traumatism (for example, radical mastectomy performed for breast cancer).

Experts identify a number of predisposing factors for the development of seroma after breast surgery.

1. Individual reaction of the body to the used endoprosthesis. Any type of implant is for female body foreign body, so many women may experience accumulation of serous fluid. At normal condition In some patients, any consequences are short-term and disappear within a week, but with individual intolerance to the material used in the manufacture of the implant, some experience the formation of scar tissue in the mammary gland.

2. Squeezing of soft tissues - with a large mechanical effect on soft tissues there is a violation of the outflow of lymph. Therefore, later it begins to accumulate, gradually transforming into a serous fluid.

3. Damage to the lymph nodes. If blood vessels, especially lymphatic vessels, were damaged during surgery, the risk of seroma increases significantly.

4. Increased tissue bleeding. There are many blood vessels in the mammary gland and if they are damaged, blood can penetrate into the breast tissue and transform into a serous fluid.

5. Hematoma. When the hematoma resolves in the soft tissues of the mammary gland, a large amount of "ichor" accumulates, which is converted into a serous fluid.

6. Poor drainage. In the process of any surgical intervention, lymph is released and if it is not removed in a timely manner, then there is a risk of developing pathology. Especially a lot of lymphatic fluid is released during operations for the oncological process.

7. Individual intolerance to the suture material. For the operation, high-quality threads are used to connect the wound, but some women may develop an allergy to the suture material. In response to this, the body forms a serous fluid - a seroma is formed.

In addition, predisposing factors for the development of seroma include the presence of various pathologies chronic nature: diabetes, hypertension, obesity, etc. To avoid the development of seroma after breast surgery, a woman should regularly visit a mammologist. Only a doctor can timely determine the initial stages of this process and prescribe appropriate therapy.

Symptoms

According to statistics, seroma occurs only after breast surgery. Therefore, a woman is advised to closely monitor the healing of postoperative sutures, as well as pay attention to any symptoms that appear. So, the development of seroma is accompanied by specific symptoms:

chest deformity. There is an unnatural increase or change in the shape of the breast, which can be easily diagnosed even with a visual examination;

swelling of the chest. Serous fluid can enter the soft tissues of the breast, and many patients experience swelling of the breast;

Discomfort and pain in the breast area. Most girls experience pain when touching their breasts;

hyperemia of the epithelium, or redness of the skin (in a simple way). With the stagnation of serous fluid, the blood vessels of a woman experience great pressure, provoking the destruction of capillaries. As a result, the skin may turn red;

The appearance of liquid in the area of ​​​​the seams is rare sign, but still observed in 10% of girls faced with seroma.

Possible consequences

Most girls and women believe that seroma is a benign pathology that passes on its own. In part, this opinion is true, but sometimes an inattentive attitude to one’s health provokes the appearance serious pathologies:

Formation of a serous fistula - serous fluid is released through postoperative sutures. In addition, in the case plastic surgery there is an infection of the implant;

The development of capsular contracture is a pathological process that provokes an increase in soft tissues, gradually forming a capsule. Outwardly, this greatly disfigures the skin;

Suppuration in the area of ​​implant placement - when fluid stagnates, the inflamed chest area becomes vulnerable to "attacks" of pathogenic microorganisms.

Diagnostic measures

If a seroma is suspected after breast surgery, a woman should immediately visit a specialist. The attending physician will conduct a visual examination of the patient's breasts and may prescribe an additional examination:

Ultrasound - allows you to identify any changes in the operated area;

X-ray mammography - is performed to determine the condition of the mammary glands, as well as to identify any seals in the mammary gland (examination is prescribed for women aged 40 years and for patients after surgery);

MRI - allows you to monitor the condition of the installed implants, as well as to identify the appearance of any deviations on the early stage.

Treatment

As statistics show, in 90% of cases of seroma after breast surgery, the pathology resolves on its own within 5–20 days, but sometimes this does not happen and more dangerous consequences (primarily purulent-inflammatory) begin to develop. With a strong stagnation of fluid, the patient needs specialized treatment. In modern times, seroma is treated in two ways:

· vacuum aspiration;

application of drainage.

vacuum aspiration

Vacuum aspiration has been actively used in the treatment of serous fluid stasis for many years. By cons similar treatment can be attributed to the fact that it is effective only in the early stages of the onset of pathology.

When performing vacuum aspiration, a device with an attached hose is used. This tube is introduced into the liquid stagnation zone and “sucked off” by vacuum (negative pressure created by the aspirator).

When using this method of treatment, doctors do not have to open the wound again. In addition, this operation helps in the healing of sutures after surgery on the chest. Many experts recommend vacuum aspiration not only in the treatment of seroma, but also in preventive purposes immediately after surgery, especially if it was performed for breast cancer.

Drainage application

Another popular treatment for seroma is drainage. This method of therapy can be used regardless of the stage of pathology development. This is the main advantage in comparison with vacuum aspiration.

When draining, all the accumulated fluid comes out through the installed drainage. In order not to provoke any dangerous consequences, it is better to use disposable sterile drains. If the clinic does not have such an opportunity, then the drainage tubes should be thoroughly sterilized and disinfected. Such activities reduce the risk of inflammatory complications.

All manipulations can be carried out through the sutures left after the surgical intervention, or a special puncture, which is done immediately before drainage. After the introduction of the drainage, it is fixed with sutures and left for several days, during which the area of ​​accumulation of serous fluid and the sutures are treated with a solution of brilliant green.

To pump out serous fluid, a rubber drainage tube or silicone is currently used. They practically do not prevent the patient from leading an active lifestyle (its activity, of course, corresponds to the days of the postoperative period). In order for the liquid to flow out well, a medical pear is connected to the outer end of the tube. It creates a negative pressure, so the serosa is constantly "sucked away".

Since the serous fluid has a high viscosity, the patient should be in a horizontal position and preferably on her back. This is necessary so that the patient can independently care for the drainage tube. All manipulations are carried out directly under supervision medical workers, to do any manipulations on their own initiative is strictly prohibited.

Prevention and treatment

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Preventive actions

To reduce the risk of developing seroma after breast surgery, experts recommend following some rules:

refuse to carry out plastic surgery if the thickness of subcutaneous fat in the operated area exceeds 5 cm (before this, it is necessary to reduce weight);

before the stitches heal, they must be treated with a special disinfectant solution, as well as a daily change of postoperative dressings;

The patient should monitor the sterility of the wound and regularly visit a specialist who will monitor the healing process and identify the slightest signs of deviation from the norm;

To avoid accumulation of serous fluid, postoperative suture it is recommended to install special bags with a load (they squeeze the vessels, therefore, reduce the percentage of fluid leakage);

within 2 months after the surgical intervention, the patient must wear compression underwear or a bandage;

Normalize your diet and include protein foods, as well as fruits and vegetables in the menu. This will strengthen immune system and normalize its functionality;

Avoid using harmful products food (alcoholic drinks, sweets, fatty and spicy dishes);

make sure that the wound is completely sewn up and does not have any pockets through which pathogenic microorganisms can enter the body and cause an inflammatory process;

stay more often fresh air;

Normalize your daily routine. A woman should fully rest and sleep at least 7 hours a day.

The development of a seroma after breast surgery is by no means a harmless phenomenon, and if left untreated, it can provoke the appearance of dangerous pathologies. That is why you should not neglect your health, and if the patient shows signs of accumulation of serous fluid, you should immediately seek medical advice. medical care. Only a doctor can make an accurate diagnosis and choose effective method treatment of this pathological process.

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Seroma symptoms after breast surgery

The presence of seroma after breast surgery is most often observed with the use of large implants and breast augmentation. Fluid accumulates under the skin and can cause them to stretch. Subsequently, the breast becomes less elastic and sags.

• 1 Reasons
• 2 Symptoms
• 3 Diagnostics
• 4 Treatment and prevention

Causes

Seroma after mammoplasty is considered a complication not so much dangerous as unpleasant.

The main causes of occurrence:

• During the operation, the lymphatic vessels were affected - restoration of the vessels is observed already on the first day after the surgical intervention, however, in some cases, the process is much slower, which leads to the accumulation of lymph.
• Negative reaction to sutures - even a wide range of modern suture threads cannot guarantee that the body will not react negatively to foreign object. Excessive use of suture material also threatens with complications.
• Bleeding of tissues appeared - small capillaries may well penetrate into the tissues of the gland and settle at the site of the implant, provoking the accumulation of lymph.
• Poorly performed drainage procedure - in order to remove excess fluid during any operation, a drainage system is used. If the procedure was carried out incorrectly, then perhaps the cause of seroma lies precisely in this.
• Rejection of the prosthesis - modern biomaterials used for the manufacture of implants, in most cases, normally take root in the human body. However, there is still a small chance of rejection. At the moment, scientists have not been able to develop a system for detecting negative reactions to the implant before surgery.
• The appearance of a hematoma on the chest - with the formation of a hematoma after surgery, it is necessary to regularly consult with the attending physician, since tissue healing can lead to the accumulation of sanious substances and the onset of seroma development.

Women who have had a mastectomy have the greatest risk of developing a seroma after surgery, due to the active development of the lymph nodes. Factors that increase the risk of its occurrence include: diabetes mellitus, obesity, elderly age, increased blood pressure.

Symptoms

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Timely diagnosis and treatment of lymph accumulations in the tissues of the mammary gland will save you from unpleasant consequences. It is for this reason that it is necessary to regularly consult with a specialist and pay attention to any discomfort in the chest area.

Seroma symptoms after breast surgery:

• Redness - the color of the skin in the place where the liquid is concentrated can be from yellow to scarlet due to the pressure exerted by the liquid on the vessels, which subsequently begin to burst.
• Deformation of the mammary gland - swelling may appear in the area of ​​lymph accumulation, as well as an increase in the gland, a change in its contours, and a displacement of the nipple.
• Serous substance penetrates through the wound - in women with thin skin, this complication is quite common. A fistula may even form on the surface of the skin, through which the fluid will exit.
• Swelling of breast tissues - the liquid may well penetrate into the soft tissues of the breast, which is why in some places there is excessive elasticity of the skin.
• Painful sensations- pain with seroma is insignificant, but may increase with palpation, walking or physical exertion.

If at least one of the above signs has been noticed, it is urgent to inform the doctor about it. Diagnosis and timely initiation of treatment allows you to eliminate the problem quickly enough.

Diagnostics

Complications arising after surgery, in particular gray breasts, can be diagnosed using one of three studies:

1. Ultrasound of the mammary glands - allows you to recognize the pathology at the earliest stages of its development. All changes in the glands after mammoplasty can be monitored using ultrasound. ultrasound gives detailed information about the stage of seroma development.
2. MRI - magnetic resonance imaging has a significant advantage due to the fact that there is no even the slightest dose of radiation and is carried out taking into account individual characteristics the patient's body. With the help of MRI, the condition of the breast is monitored after surgery. Tomography allows you to accurately determine the presence of contracture or seroma.
3. Mammography - X-ray examination glands is contraindicated in girls under 40 years of age. However, a mammogram is recommended for anyone who has had any breast surgery. The study allows you to accurately determine the condition of the mammary glands, as well as detect the presence of fluid and neoplasms.

Treatment and prevention

When lymph accumulates in the tissues and causes significant discomfort, there are several ways to solve the problem: medical and surgical. In some cases, in the presence of a large formation, it is required to combine both methods for maximum treatment efficiency.

• Medical method treatment of seroma is quite simple and includes taking antibiotics with a wide spectrum of action, as well as anti-inflammatory drugs. With a small accumulation of fluid, doctors recommend using only medications.
• To use the second method, drainage will definitely be required. Installing a drainage tube allows you to get rid of lymph and other fluids within 2-3 days, depending on the amount of accumulated substance. For the procedure, the surgeon makes punctures close to the wounds. This requires regular treatment of the skin with brilliant green to prevent infection from entering the gland. The drainage is strictly monitored by a specialist and if the tube falls out, it performs an urgent replacement. The surgeon removes the drainage system.
• A third method of liquid elimination is also possible by vacuum aspiration. During the procedure, the serous substance is completely pumped out of the wound or the place of fluid accumulation. It is used in most cases at the very beginning of the postoperative period, which guarantees fast healing wounds.

Seroma prevention is carried out in three stages: preoperative, interoperative, postoperative.

• Immediately before the operation, the patient must hand over all necessary tests, undergo a breast ultrasound and ECG procedure, consult a qualified plastic surgeon and gynecologist.
• Interoperative prophylaxis is carried out by the surgeon. He chooses a rational area for implantation of the implant, is responsible for correct location incisions, adequate drainage during surgery and good use of suture material.
• Postoperative prophylaxis is entirely the responsibility of the patient. The following rules are obligatory: regular visits to the attending physician, wearing special underwear, no excessive physical activity.

If you are reading these lines, we can conclude that all your attempts to combat chest pain were unsuccessful ... Have you even read something about medicines designed to defeat the infection? And this is not surprising, because mastopathy can be deadly for a person - it can develop very quickly.

• Frequent chest pain
• Discomfort
• experiences
• Allocations
• Skin changes

Surely you know these symptoms firsthand. But is it possible to defeat the infection and not harm yourself at the same time? Read the article about effective, modern ways to effectively deal with mastopathy and not only... Read the article…

The procedure for getting rid of the serous substance is quite simple and painless. Otherwise, the consequences can be quite serious. The main thing - do not skip the doctor's consultations and strictly follow his recommendations.

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Seroma after mammoplasty - symptoms, breast, signs, treatment

A seroma is an accumulation of fluid or lymph after plastic surgery to correct the breast.

The accumulation of fluid is mainly formed after breast augmentation and when using large implants. This accumulation of the substance leads to stretching of the skin and leads to its sagging.

The accumulation of serous matter after mammoplasty has a straw-yellow color. Depending on the composition of the cluster, it can change its color and move from yellow to red.

Causes

The causes of this complication may be:

• The reaction of the body to the endoprosthesis. A prosthesis for a woman's body is foreign body, which may be rejected. Implants are made of biological material, so the probability of rejection is very small and passes quickly. But there is always a percentage of women who are sensitive to biological material which may increase the risk of fluid accumulation after surgery. But modern surgery still cannot find out the body's reaction to the implant before the operation;
• Damage to the lymphatic vessels. Such a reason for the accumulation of fluid in the chest is formed when blood vessels are damaged during the operation. Vessels are restored during the first day after the operation, but sometimes this process slows down, which leads to the release of lymph;
• Bleeding tissue. The small capillaries surgical intervention tend to seep into the soft tissues of the breast and form a serous substance at the site of the implant;
• The presence of a hematoma. When the resorption of the hematoma begins, accumulations of sanious substances and the formation of a seroma are formed. Therefore, it is necessary to observe the patient for several days after the operation;
• Lack of normal drainage. Any operation, like mammoplasty, is accompanied by the release of lymph, and if it is not removed in time, this provokes the appearance of complications;
• The reaction of the body to the suture material. In modern surgery, there are many high-quality surgical materials, but none of them is ideal. Also, with a large use of absorbable threads, they lead to accumulation of the substance.

Photo: Seroma

Accumulation of serous material after mammoplasty appears within 5-7 days after surgery.

One of the significant signs that affect the accumulation of fluid in the breast is a mastectomy (removal of the mammary gland), in which the appearance of lymph nodes increases.

Another factor contributing to the appearance of serum may be inflammatory processes in places of skin injury.

There may also be other factors such as:

1. diabetes;
2. excess weight. Large thickness of subcutaneous fat, increases the risk of fluid;
3. increased blood pressure;
4. age.

Seroma symptoms after mammoplasty

Do not forget that seroma appears in many women after breast correction, so you should go to a consultation with a specialist and monitor the healing process and, of course, pay attention to the symptoms of fluid manifestation for its timely prevention and treatment.

The main symptoms of fluid accumulation may include:

• change in the shape of the breast. The breast increases in volume, a bump may appear in the place where the fluid is collected, the contour changes and the nipple is displaced.
• soft tissue swelling. Since the liquid does not remain outside the boundaries of the capsule, it has the ability to penetrate into soft tissues and, when probed, a certain elasticity and tension of the skin can be felt;
• pain in the area of ​​fluid accumulation. Usually the pain is normal and moderate, but with pressure pain intensify. Pain can also be felt during physical exertion and walking;
• redness of the skin in the area of ​​the seroma. This symptom is explained by the fact that the liquid exerts pressure and destroys small vessels, and therefore the color in the accumulation area may change;
• secretion of serous substance through the edges of the wound. Such a symptom is extremely rare, but if such a complication exists for a long time, then an exit may form - a “fistula”, through which the substance wakes up to go outside. This complication is typical for patients with thin skin.

After breast augmentation, the patient notices that the breast is enlarged, swelling appears, which increases every day, redness appears in the area of ​​accumulation of the substance, and pain becomes more frequent.

Video: What this complication looks like

Diagnostic methods

Methods for diagnosing complications include:

1. ultrasound procedure;
2. x-ray mammography;
3. Magnetic resonance imaging.

With the help of ultrasound, it is possible to determine the internal changes occurring in the breast area after mammoplasty, determine the degree of development of the seroma and diagnose it in the early stages of formation.

X-ray mammography is indicated for all women who have ever had breast surgery, as well as for women over 40 years old.

This research method helps to assess the nature of the condition of the mammary glands and helps to determine the nature of the formation of nodes, seals and the formation of fluids in the chest area.

Unlike x-rays, magnetic resonance imaging implies the absence of radiation exposure and diagnosis is carried out for each case separately.

Magnetic resonance imaging can help monitor the condition of implants after mammoplasty, and also helps prevent the development of complications such as seroma and contracture.

Methods of treatment

It is possible to treat such an education in the chest as gray by two methods, such as surgical and medical. With large formations, two methods can be treated simultaneously.

The surgical method is accompanied by the presence of adequate drainage.

Drainage is installed to remove serous fluid and can be from two to three days. By the amount of the separated volume of the substance, the specialist can judge whether it is worth removing the drainage or not.

Drainage is a fairly popular method of treatment, in which the process of removing the separated substance from the places of accumulation takes place.

Special devices can be removed from the wound, but in general, specialists remove fluid through special punctures located around the wounds.

The skin that is near the installation site of the drainage system must be wiped with a solution of brilliant green.

Before starting the drainage procedure, all devices must be sterile and treated with sodium chloride in a proportion of 0.9%.

The medical worker must monitor the operation of the drainage system, if the tube falls out, it must be replaced with a new one. Drainage removal should only be done by a professional.

Another treatment for seroma is vacuum aspiration. When carrying out this method, the serous substance is suctioned from the place of accumulation of the serous substance or postoperative wounds.

This method of treatment is most often used in early postoperative period and provides fast healing postoperative wounds.

The drug method of treatment involves the use of anti-inflammatory drugs and broad-spectrum antibiotics.

If the formation of fluid is small, then it is worth doing only by taking medications.

dangers

A very big mistake is the assertion that the seroma itself will resolve without additional treatment and prevention.

In most cases, this may be true, but there is always a risk of an increase in the volume of fluid, which by itself cannot disappear and cannot be absorbed.

This leads to further complications such as:

1. The formation of a serous fistula. In this case, the serous substance independently seeps through the soft tissues. Most often, these are the edges of the wound. Such an expiration can last up to several weeks, which contributes to the infection of the endoprosthesis, which entails a second operation;
2. Development of capsular contracture. The accumulation of fluid accompanies the inflamed processes, which ultimately leads to an increase in excess tissue. In turn, this tissue contributes to the development and formation of the capsule;
3. Suppuration of the place where the implant is located. Serous substance ideal places for the accumulation and development of bacteria, which can lead to suppuration of the implant pocket.

Prevention

The best solution to the problem of fluid accumulation is a timely visit to the doctor and prevention.

Conventionally, the prevention of fluid prevention can be divided into at the level of:

1. Preoperative;
2. Interoperative;
3. Postoperative.

Preoperative prophylaxis is:

• delivery of tests;
• consultation and selection of a plastic surgeon;
• Ultrasound of the mammary glands;
• electrocardiogram;
• gynecologist consultation.

Interoperative prophylaxis is directly related to the actions of a plastic surgeon and the methods of plastic surgery, which include:

• the correct choice of the area for the location of the implant;
• adequate incisions;
• timely wound drainage;
• quality stitching.

Postoperative prophylaxis is directly related to the behavior of the patient during the rehabilitation period.

AT postoperative period The patient must comply with the following rules:

• wearing compression underwear;
• attending all consultations and following all the recommendations of the attending physician;
• limitation of physical activity and movement.

Photo: Compression underwear

Compliance with all preventive measures and careful attitude to your health will give you a good aesthetic result after the operation and reduce the risk of complications after mammoplasty.

To prevent the appearance of a serous substance, the following actions also include:

1. suturing the wound without leaving pockets;
2. pressure bandage on the wound area for several hours;
3. constant use of antiseptics and antibiotics at all stages of treatment.

Experts advise taking such complications as lymphorrhea very seriously and approaching the choice of a plastic surgeon with all responsibility.

Large accumulations of fluid require vacuum suction, and in complicated cases, the installation of a drainage system.

Infections can get into the gray, and therefore you need to take anti-inflammatory drugs and in some cases surgery is required. Therefore, it is better to prevent the formation of a liquid substance at an early stage of its development.

1. antibiotics;
2. antibacterial agents. "Nise" and "Ketorol" are very popular;
3. laser therapy;
4. the wound after the operation must be carefully treated and prevent infection;
5. in the treatment, you can use ointments such as Veshnevsky ointment or Levomikol. You can use such ointments up to three times a day, gently pressing on the inflamed skin.