title: Cylinder syringe suction: a simple and efficient technique for the evacuation of subcutaneous hematoma.
abstract: BACKGROUND
  Subcutaneous hematoma is commonly caused by trauma or surgery. Proper treatment of the condition is needed to avoid severe complications. The present paper introduces a simple technique of hematoma evacuation, called cylinder syringe suction (CSS). Experiments were also performed to determine the detailed mechanism underlying its effectiveness.
  
  
  METHODS
  The CSS procedure was performed as follows. A cylindrical plastic cylinder syringe was used. Either a few stitches were removed or a very small incision was made on the site of the hematoma. The edge of the syringe was compressed to the skin, which was covered by a thin hydrocolloid dressing. Vacuum aspiration was enforced at the site of the wound or incision, and the hematoma was gradually aspirated.For the experiment, house rabbits were used. Hematoma evacuation was performed in 4 different ways, including needle aspiration alone (group 1), needle puncture followed by CSS (group 2), and creation of a small wound (5 mm) followed by needle aspiration (group 3) or CSS (group 4). The amount of evacuated hematoma and the suction pressure created by each of the 4 methods were compared.
  
  
  RESULTS
  Group 4 showed the highest suction pressure and the greatest evacuated amount of hematoma. High suction pressure was also obtained in group 1; however, the amount of evacuated hematoma was small as the other 2 groups.
  
  
  CONCLUSIONS
  The CSS technique becomes effective mainly by creating high suction pressure, and the opening of a small wound enables the viscous coagula to pass through the skin.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, Japan. ayhayasi@juntendo.ac.jp
authors.forename: Ayato
authors.initials: A
authors.lastname: Hayashi
authors.forename: Norifumi
authors.initials: N
authors.lastname: Matsuda
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Horiguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Komoto
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Natori
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Komuro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mizuno
mesh_terms: D000818:Animals; D047070:Bandages, Hydrocolloid; D005141:Eyelid Diseases / Q000209:etiology / Q000601:surgery; D006406:Hematoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D011312:Pressure; D011677:Punctures; D011817:Rabbits; D040521:Subcutaneous Tissue / Q000601:surgery*; D013396:Suction / Q000295:instrumentation / Q000379:methods*; D013594:Syringes; D014618:Vacuum; D015051:Zygomatic Fractures / Q000150:complications