Seroma (peri-graft seroma), also called peri-graft fluid accumulation or hygroma, refers broadly to sterile, clear fluid that collects around a synthetic graft after implantation, usually enclosed in a pseudo-membrane. It is a rare complication of graft implantation. Because it occurs rarely and may appear a long time after implantation (the literature reports 25% within the first month and cases arising 1 to 10 years after surgery), and because most cases have no symptoms, estimating its prevalence is limited; the reported incidence in the literature ranges from 0.48% to 31%, and seroma has been reported with grafts of every material, diameter and placement site.
The cause of seroma is still not firmly established, but two hypotheses may explain how it forms:
- Clear fluid that seeps out of the blood inside the graft through the graft wall by ultrafiltration and accumulates around the graft
- Clear fluid produced by damage to the surrounding subcutaneous tissue when the graft is implanted
Treatment and management
For a seroma that keeps seeping from the graft, sealing can be achieved by injecting fibrin glue or topical thrombin (thrombin preclot) or by wrapping. Surgical drainage together with seroma removal or graft replacement is the more definitive treatment.
