A clinical study of vault hematomas after different types of ...

Hemant Deshpande et al, Int J Pharm Biomed Sci 2013, 4(3), 91-95
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hematoma was 19.4%, 70% had small-sized hematoma and
30% had large-sized hematoma. In other studies, incidence of
postoperative hematoma was detected 25-98% [5,8]. The
incidence of vault hematoma was found 19.4% in present
study. In these patients, 40%(8/20) had fever while only
2.4%(2/83) of cases without vault hematoma suffered from
fever due to UTI. Study done by Cem Dane et al [17]
indicates out of all women having vault hematoma,
70%(14/20) had small-sized hematoma and 30% (6/20) had
large-sized hematoma. Fifty percent of patients (3/6) with
large-sized hematoma, as compared to only 35%(5/14) with
small-sized hematoma, suffered from febrile morbidity.
Large-sized hematomas drained by vaginally, while all smallsized
pelvic hematomas managed by watchful expectancy
successfully. The significant difference was found mean
hemoglobin drop and postoperative stay in the hematoma
group or without hematoma group, concluding the
importance of sonographic detection of vaginal vault fluid
collection after hysterectomy.
Table 8
Assessment of post-operative morbidity parameters in patients with vault
hematoma
Parameters
Vault hematoma
Present (n=18) Absent (182)
Febrile morbidity 5(27.77%) 1
Drop in hemoglobin 4(5%) 80
Blood transfusion 3(33.33%) 10
Hb drop in g/dL 2.78 averagely 1.24 averagely
Table 9
Relation between size of hematoma and post operative morbidity
Small Medium Large
Total no of patients 6 7 5
Febrile morbidity 0 3 2
Average Hb drop 1g% 3g% 4g%
Blood transfusion 0 2 1
Mean duration of hospital stay 10 days 14 days 20 days
Readmission 0 0 1
Table 10
Relation between suturing technique and vault hematoma
Suturing technique Total no of cases Hematoma cases (%)
Continuous 100 9(9)
Intermittent 50 1(2)
Continuous locking 50 8(16)
Total 200 18(9)
χ 2 =5.98, P