Subcutaneous Hematoma: Causes and Treatment Options - Surgery

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Subcutaneous hematomas, often referred to as "blood blisters" or "blood collections under the skin," occur when blood vessels are damaged, leading to bleeding beneath the skin's surface. This can happen due to trauma, such as being bitten by a dog, even if the skin appears intact. In your case, the fact that there is a noticeable bump under the skin suggests that blood has pooled in that area, creating a hematoma.


Causes of Subcutaneous Hematoma
The primary cause of a subcutaneous hematoma is trauma. When the skin is impacted, small blood vessels can rupture, allowing blood to leak into the surrounding tissue. This can occur without any visible skin damage, as in your situation. Other potential causes can include:
- Blood clotting disorders: Conditions that affect your blood's ability to clot can lead to more significant hematomas.

- Medications: Certain medications, especially anticoagulants (blood thinners), can increase the risk of hematoma formation.

- Age: Older adults may have more fragile blood vessels, making them more susceptible to hematomas.


Treatment Options
In most cases, subcutaneous hematomas are self-limiting and will resolve on their own without the need for surgical intervention. Here are some general treatment options and recommendations:
1. Observation: If the hematoma is small and not causing significant pain or discomfort, it may be best to simply monitor it. The body typically reabsorbs the pooled blood over time, which can take days to weeks.

2. Ice Application: Applying ice to the affected area can help reduce swelling and alleviate pain. It is advisable to apply ice for 15-20 minutes every hour as needed during the first 24-48 hours after the injury.

3. Compression: If the hematoma is large or painful, gentle compression with a bandage may help reduce swelling. However, be cautious not to apply too much pressure, as this can impede circulation.

4. Elevation: Keeping the affected area elevated can also help reduce swelling and promote healing.

5. Pain Management: Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to manage discomfort. However, avoid aspirin, as it can increase bleeding.

6. Medical Evaluation: If the hematoma is large, continues to grow, or is associated with severe pain, it is essential to seek medical attention. A healthcare provider may perform an ultrasound to assess the extent of the hematoma and determine if any intervention is necessary.


When to Seek Medical Attention
You should seek medical attention if:
- The hematoma is rapidly increasing in size.

- You experience significant pain that is not relieved by over-the-counter medications.

- There are signs of infection, such as increased redness, warmth, or discharge from the area.

- You have difficulty moving the affected area or experience numbness or tingling.


Conclusion
In summary, subcutaneous hematomas typically resolve on their own, but proper care can facilitate healing and reduce discomfort. Applying ice, maintaining elevation, and monitoring the area are key steps you can take at home. However, if you notice any concerning symptoms or if the hematoma does not improve, it is crucial to consult a healthcare professional for further evaluation and management. Always prioritize your health and well-being, and don't hesitate to seek help when needed.