A Simple, Reliable, and Inexpensive Method for Seroma Drainage

Im ages Seromas and hematomas are relatively common complications of a variety of surgical procedures. In plastic surgery, they may occur in the postoperative period of abdominoplasty or abdominal wall reconstruction, mastectomy or breast reconstruction, lymphadenectomy, or voluminous neoplasm excision. Furthermore, in our experience, seromas are particularly common in surgical procedures involving the use of biological substitutes [1]. Clinical treatment of seromas is usually performed by repeated evacuation by means of suction using an appropriately sized syringe (usually 10–50 mL in volume) according to the amount of fluid to be evacuated [2]. In some cases, an ultrasound examination can highlight the depth, volume, and extension of the fluid. In the case of seromas that are more than 100 mL in volume, the use of several syringes is necessary. Whenever a syringe is filled, it should be replaced or depleted by unplugging it from the hypodermic needle, thus exposing the patient to a high risk of infection. Therefore, negative pressure cannot be maintained continuously [3]. In order to avoid these issues, we have developed a new and simple method that allows us to reduce the material used and to minimize the risk of infection. This device involves the use of basic materials that are easily available in every hospital: a hypodermic needle, preferably a 20 G syringe needle, and highvacuum Redon drainage. For this system, we used a high-vacuum Redon bottle (Drainobag 300V Lock, B-Braun, Melsungen AG, Germany); however, any kind of drainage can be used. First, it is necessary to make an oblique incision in the terminal portion of the rubber connector, taking care not to excessively shape the rubber in order to maintain the negative pressure. It is now sufficient to plug the connector into the needle hub to achieve the drainage system (Figs. 1, 2). Usually, an accurate plug between the needle and the connector is sufficient to maintain the negative pressure. To avoid disconnections, due, for example, to the stretching of the drainage tube, a plaster may be added to the connection. After pricking the skin and identifying the seroma, it is possible to open the drainage. The liquid will be drained from the drainage system without the use of different syringes. If a change of the drain site is