Hematomas

Wound hematomas result from unrecognized inadequate hemostasis. Patients have pain, pressure, and swelling within the wound. Patients with wound hematomas may be febrile and have sanguineous or serous wound drainage. Differentiating between hematoma and wound infection can be difficult. A few sutures are removed to allow the hematoma to drain, and cultures are obtained. If there is no evidence of infection and hemostasis can be maintained, the patient can be discharged. In patients with a hematoma of the neck or who have undergone vascular surgery, extreme caution and consultation are appropriate.

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