Professional opinions re hemtomas

[hoolahan, ASN, RN]

I have a friend whose dad had to have a AAA, post-op, lost pulses in the leg, went back for thrombectomy, a clot the lenght of the LE was removed! Doing better, but then he developed a hematoma along the thrombectomy site, and it is again compromising the circ. He has pulses, but little toe is blue, and my friend is rightfully concerned.

She asked me for advice since I did so much vas surgery experience, but to tell ya the truth, we didn't have too many hematomas like that, and if so, they went right back to surgery.

She asked if he should be having warm compresses to the leg, and I truthfully couldn't answer that ?. I did a search today, and pretty much the only Rx I could find is aspirating the hematoma or using leeches, which I'm pretty sure has not been brought up as an option, or would be.

Does anyone have any evidence-based treatments or comfort measures you use for hematomas, or a protocol once one is there? There are hundreds of protocols and practices to prevent hematomas, but not much out there to treat one, esp icirc is quais-compromised like this.

[Jay Levan]

Found a great site today haven't had time to completely research it yet, but you may have the time today or tomorrow site is as follows http://health.discovery.com/minisites/blausen/blausen.html (hope this helps. Also http://www.webmd.com) My experience with your subject matter is limited, aand that is why I'm suggesting these sites for you or for your friend. Jay

[fedupnurse]

Did they do an ultrasound to ensure that they aren't dealing with a pseudoaneurysm rather than a hematoma? I have seen plenty of hematomas over the years, bad ones, and never saw circulation compromised to the extent you are describing. Does this man also have PVD or Diabetes? I hope they are also keeping an eye on his renal status because that is a huge concern after AAA repair, particularly because it sounds like he went to Specials and had a dye procedure as well. Tell your friend to find out what his Creatnine is. If it is elevated or if his output is decreased they may want to play it safe and get the renal people in early.

Hope he gets better soon.

Regards,

[Huganurse]

Hi hoolahan, If you friend is not getting answers I would tell her to get a second opinion stat. Oh, and btw, it's really sweet of you to be so concerned and ready to help. Kudos to you. Hugs to you and your friend. :)

[Fgr8Out]

I was going to put my 2 cents in... but the responses you've received thus far addressed all my own suggestions...

Good luck, Hoolahan and great job, folks!!