Hematoma of the Lower Extremity: Operative Interventions in the Wound Clinic Setting

Terry Treadwell, MD, FACS, FAAWC


Wounds. 2022;34(3):90-93. 

In This Article

Case 1

A 74-year-old male with diabetes mellitus, who was taking antiplatelet agents, sustained an injury to the right leg in a motor vehicle accident 1 week before presenting to the wound center (Figure 2A). At the time of initial evaluation in the emergency department (ED), an abrasion and swelling of the leg were noted. The patient self-reported that he was prescribed antibiotic cream to apply to the abrasion and was told the problem would resolve. One week after receiving the cream, the patient presented to the wound clinic with worsening leg swelling and pain. The wound was found to have 2 areas of skin necrosis at the site of the original injury and a 9-cm underlying hematoma that was visibly enlarging. In the same visit, the hematoma was evacuated under local anesthesia (Figure 2B), and 2 bleeding points found in wound bed were controlled with sutures and oxidized regenerated cellulose (ORC)/collagen/silver dressings. One week after the hematoma was evacuated, the condition of the wound and patient's quality of life had significantly improved. At 12 weeks following the procedure, the wound was healed (Figure 2C).

Figure 2.

Case 1: leg wound with hematoma at (A) 1 week following injury and (B) at evacuation in the clinic. (C) Wound healed 12 weeks after evacuation.