Successful treatment of a chronic abdominal wall seroma with the polysaccharide 4DryField(®) PH − A case report

INTRODUCTION: Seroma formation is one of the most prevalent complications after liposuction, abdominoplasty, mastectomy or hernia repair. They can disappear without treatment, but also may persist and require complex therapy. This report describes how 4DryField(®) PH polysaccharide powder successfully was applied for chronic seroma therapy. PRESENTATION OF THE CASE: An 80 year old male patient presented with a persistent seroma (1000 cm(3) volume) resulting from liposuction about 15 years ago. In a first approach he was treated using en bloc excision without opening the capsule. Three month later the patient presented with a recurrent seroma of the same size. This time 1100 cm(3) bloody discolored fluid was aspirated. The skin was lifted using a redon tubing drawn through the whole length of the wound cavity. This allowed even distribution of 4DryField(®) PH powder (10 g) within the former seroma cavity. Computed Tomography (CT) imaging after 4.5 month and sonographic examination after an additional year confirmed treatment success. DISCUSSION: Besides conventional methods for hemos-/lymphostasis several adjunct measures like fibrin sealants, medication with corticoids and diurectics have been proposed for seroma prevention/therapy, unfortunately, with conflicting evidence. In an experimental study seroma prevention with a polysaccharide was demonstrated; however, clinical proof is missing. This case provides first clinical evidence that 4DryField(®) PH polysaccharide powder evenly distributed in the former seroma cavity can prevent its recurrence. CONCLUSION: 4DryField(®) PH powder treatment of seroma is a promising new approach for prevention and treatment of chronic seroma.