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Treatment for water between muscles under the skin (hematoma)

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My father is 62 years old and 8 weeks ago he fell off a horse and the horse fell on top of him...on his thigh. At first it was a huge black spot, but as the time went by, there formed a lot of water between his muscles underneath the skin. He went to our local doctor and they drained the water, but it keeps making water under the skin, between the muscles. He went back a couple of times already, the water that gets drained each time, does get less, but the problem does not seem to get better. He is in quite some pain, but not unbearable. Is there any other treatment besides the draining that he can do?
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replied November 19th, 2011
Especially eHealthy
malani,

You need to close down the potential space. The muscle that was injured in the fall, actually dies and undergoes necrosis. This causes an area for serum (the liquid portion of blood) to seep into. This area will continue to form seromas, as long as there is space for the liquid to go into. The area will continue to get smaller and smaller, but as long as fluid is allowed to get in there is will keep it open. The sides of the walls have to scar together. As long as there is fluid in there, that cannot happen.

It is very important to keep the area compressed. You can use Ace wraps or a neoprene sleeve. The compression has to be constant, except when showering. The problem comes in, in that you want it to be tight, but not too tight as to cut off the circulation to the lower leg.

If there is no space for the serum of leak into, the seroma will not form.

Once the walls of the area have scarred down, the swelling will stop. However, after severe contusions like this, the patient will develop a significant amount of scar tissue. This can sometimes keep the knee from moving. So, while the wrap is on, it is very important to move the knee through a full range of motion every day.

Good luck.
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