Haematomas
Cosmetic Surgery - Plastic Surgery - Aesthetic Medicine - Reconstructive Surgery
A haematoma is an effusion of blood (haemorrhage) which will be
collected in a cavity that has formed within a tissue or between
tissues. A haematoma may form as a result of bashes and bangs, but also
when blood is taken, with detachment and swelling of the skin.
Vascular rupture is always the cause of the haematoma, whether
traumatic or spontaneous. The severity of the haematoma depends on its
volume and thus the resultant internal bleeding, but also on its
location, when there is a risk of compression of an organ (brain) or
its destruction (intracerebral haematoma).
The haematoma resolves itself spontaneously within a few weeks, and
gives way to a fibrous tissue scar. Reabsorption of the haematoma is
not without consequences for organs such as the kidney, where a
perirenal haematoma carries the risk of infection.
It is important to clear and drain surgically any reasonably significant haematoma within the body.
A haematoma may be a (rare) side effect of aesthetic and
reconstructive plastic surgery. Further surgery will be required to
clear it.
The colour of the skin over the haematoma is due to the dissipation
products of haemoglobin: biliverdin (green pigment) and bilirubin
(yellow pigment appearing red).
The classical evolution of the haematoma takes place over a fortnight.
The chronology of the evolution of the haematoma does not vary greatly
from one patient to another: the first day the haematoma is blackish,
and then it is purplish on the second and third days and bluish for a
further three to four days. The haematoma becomes greenish for five to
six days and finally yellowish for between ten and fifteen days, to
disappear completely after twenty- five days.