What is a Surgical Hematoma?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 28 October 2019
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A surgical hematoma is a collection of blood in a sac in close proximity to a surgical site. This complication of surgery can occur in many different locations and usually resolves on its own, although in some cases, the surgical site needs to be reopened to allow a surgeon to drain the hematoma and fix the cause. There are a number of potential causes for hematomas after surgery, including the use of blood thinners before surgery, poor surgical technique, and inadequate aftercare. People can reduce their risks by following directions from the surgeon to the letter after surgery.

In a surgical hematoma, bleeding below the skin leads to the formation of a pouch of blood. This can happen when a surgeon doesn't completely seal off blood vessels, when a patient strains and pops a blood vessel, or as a result of thin, friable blood vessels around the site. The surgical site may swell, and patients can also see discoloration under the skin caused by the balloon of blood.


Surgical hematomas often reabsorb. Over time, the blood will break down and be carried away, although the patient can experience some discomfort during the early healing stages. In other patients, when it is evident the hematoma is large or painful, drainage may be recommended. Simple needle aspiration can be used to quickly pull blood out of the surgical hematoma, but it often refills. In surgery, a doctor can open up the hematoma, express the blood, and find the leaking blood vessel causing the problem.

Before surgery, people are usually advised to avoid blood thinners to minimize the risk of severe blood loss during surgery and prevent post-surgical hematoma. Surgeons may ask patients to wait to go back on these medications until the initial danger phase of healing is over. To avoid hematomas during surgery, surgeons take steps like carefully sealing off vessels and waiting before closing the incision. After surgery, avoiding physical strain and blows to the surgical site are recommended to prevent surgical hematoma.

If a hematoma develops, the surgeon will want to examine the patient to decide on the best treatment option. Some patients are sent home and told to watch the swelling, while others may be advised to go to surgery for drainage and correction. People who are frustrated with hematomas should not attempt to drain them at home, as this can introduce the risks of infection, uncontrolled bleeding, and disfiguring scars.


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Post 2

I recently had a hip replacement. On the day after the surgery, I went to physical therapy. After therapy, I took a nap.

When I awakened from the nap, I noticed a large lump at the surgical area, so I called a nurse. She notified the surgeon, who ordered an x-ray of the site. After returning to my room from x-ray, I began feeling nauseated, weak, and dizzy. My BP started falling and my heart rate increased. I started losing consciousness. I woke up in the ICU with an IV in one arm, and a unit of blood running into the other arm. In all, I required four units of blood.

Here I am, 28 days later, and the "lump

" is still as huge as it was the day it developed. The doctors are still saying it will absorb, but I'm getting tired of having it hanging around! Eight months ago I had to have an L-4,L-5 spinal fusion. I developed a severe infection in that surgical area. No more surgery for me!
Post 1

I had post surgery hematomas. It happened to me not long ago. My doctor did not tell me why this happened. He put me on antibiotics twice.

After finishing the first dose, the next day I got up to go to the bathroom and as I stood up, I felt something gushing out of my body. By the time I made my way there, it kept pouring out. Brown, rotten blood was gushing out of my body. I feel that my doctor did not do his job right. A hysterectomy became a nightmare for me.

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