title: Successful treatment of a chronic abdominal wall seroma with the polysaccharide 4DryField®PH - A case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  An 80year old male patient presented with a persistent seroma (1000cm3volume) 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 1100cm3bloody 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 (10g) within the former seroma cavity. Computed Tomography (CT) imaging after 4.5 month and sonographic examination after an additional year confirmed treatment success.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  4DryField®PH powder treatment of seroma is a promising new approach for prevention and treatment of chronic seroma.
authors.affiliation: Department of General Surgery and Traumatology, DRK-Krankenhaus, Clementinenhaus, Lützerodestr. 1, 30161 Hannover, Germany. Electronic address: AKuthe@clementinenhaus.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kuthe
keywords: Chronic; Liposuction; Seroma; Starch based medical device; Subcutaneous