The ideal treatment for hematomas depends on the severity of the trauma suffered - or on the severity of the underlying condition - and on the location involved.
Hematomas: definition and causes
As we know, the hematoma is a collection of blood in a tissue or organ, accumulated following the rupture of a blood vessel, either a capillary or any other duct of the circulatory system. Blood, finding no way out, concentrates and accumulates in the compromised region.
Given the heterogeneity of the triggering causes, it is understandable that the treatments for the hematoma are multiple.
Choice of care
Moreover, it is necessary to consider another fundamental element: the choice of the ideal treatment for hematomas is also correlated to the location of the lesion, as well as to the severity of the trauma suffered. It is evident that a superficial hematoma will not be as serious as a cerebral hematoma.
According to this we understand how the approach to the treatment of hematomas is different and heterogeneous.
Cure for superficial hematomas
HEMATOMAS OF SIMPLE RESOLUTION do not require any specific medical treatment: the blood accumulated in the tissue coagulates and is slowly reabsorbed. The variation of the chromaticity of the hematoma (first from red to blue, then from violet to yellowish-green) is an important signal, a clue from which it is possible to understand that the hematoma is being reabsorbed.
Nevertheless, it is possible to adopt some small tricks to speed up the healing time of the hematoma, without taking drugs or undergoing surgical therapies.
A moderate degree of hematoma is reabsorbed more quickly when treated with ice (cryotherapy): the application of an ice bag directly on the superficial hematoma favors a vasoconstriction, which limits the leakage of blood from the vessels injured by the contusion.
DO NOT apply ice directly on the hematoma: if you do not have a special ice bag, it is recommended to wrap some ice cubes (or other frozen products) in a cloth. Next, apply everything to the hematoma. This simple trick is indicated to reduce possible cold burns.
In addition to the extraordinary vasoconstrictor capacity, ice excellently exerts a further therapeutic function: applied to the hematoma, the cold pack creates a sort of anesthesia, thus acting as a mild anesthetic. The ice bag should be placed directly on the superficial hematoma, and left there for about ten minutes. Repeat the application several times during the day (about 2-3 applications every hour), for 2-3 days.
Only when the superficial hematoma is extensive and painful, complementary palliative care is recommended: in such circumstances, it is recommended to take NSAIDs, painkillers and anti-inflammatory drugs that temporarily mask the pain caused by the bruise. Even the application of ointments with anti-inflammatory action is a good remedy to reduce pain.
Cure for subungual hematomas
Although they do not constitute a medical urgency, subungual hematomas are extremely painful: so much so that many subjects, immediately after a strong trauma to the nail, tend to faint. In this case, in addition to the application of ice on the affected finger, it is possible to resort to other treatments: when the nail bed and the edges of the nail are intact, it is possible to intervene through a perforation. This technique - also called trepanation - consists of piercing the nail using a special heated tool (needle). The tip of the needle exerts a slight compression on the nail: in this way, a small hole is formed from which the blood flows. The pressure of the needle on the nail must not be excessive and must be performed correctly: respecting this practice, the maneuver is completely painless, therefore local anesthesia is not necessary.
In the case of a more severe sub-unileal hematoma, it is possible to remove the nail.
If the hematoma is extended and the bruise is violent, it is recommended to undergo a radiological test to rule out a possible fracture of the phalanx.
Cure for complex hematomas
Not all hematomas are evident: some - the deeper ones - are not visible, but extremely dangerous. In such situations, the treatment must be prompt and immediate, to avoid irreparable sequelae.
In some cases, therefore, surgery is required, useful not only to ascertain the source of the bleeding, but also and above all to remove the hematoma.
Under the ultrasound guidance, the hematoma is emptied: this maneuver must be performed in a hospital setting, in aseptic conditions (complete sterility).
Cranial hematomas in general must be surgically evacuated: the removal of the mass reduces, consequently, also the pressure exerted by the hematoma on the brain. The hematoma is evacuated through a hole made directly in the skull (craniotomy).
Any concomitant infections must be treated with specific antibiotic therapy. For example, haematomas resulting from surgical wounds can promote the appearance of an infection, which requires immediate care to avoid the spread of pathogens in other districts.
Often, the tissue affected by the hematoma evolves into fibrosis, therefore there is an exaggerated increase in the fibrous connective component, to the detriment of the parenchymal cells. This situation, typical of muscle and subcutaneous hematomas, can cause calcifications, which are responsible for pain and thickening of the affected tissue. In this sense, the best cure for hematoma healing is shock wave therapy: it is a useful therapeutic strategy to promote and increase local capillarity and cellular metabolism, favoring the process of spontaneous tissue repair, therefore the hematoma reabsorption.
