Persistent Seroma After Abdominoplasty in a Massive Weight-Loss Patient

Furosemide (Lasix) is a common diuretic used for the treatment of postoperative edema. However, caution is advised in post-bariatric patients as many are known to be deficient in albumin, which is a necessary component for Furosemide to bind allowing the adherence of interstitial fluid leading to the excretion of water. This case report discusses identifying such nutritional deficiency and switching to a less common alternative, with proven benefits in the reduction of seroma formation and tissue edema. It is important to plan accordingly in these post-bariatric patients by obtaining preoperative lab values and encouraging preoperative protein intake of 60 g/day at minimum. If patients present with persistent postoperative seroma accumulation, serial albumin levels are helpful to identify the need for using alternative diuretic medications. An example is the use of Torsemide (Demadex); a synonymous loop diuretic with a higher bioavailability and a longer half-life compared with Furosemide. This adjustment was key in resolving our patient’s persistent seroma and accompanying symptoms.