is it a bruise or a hematoma?

How Are These Treated?

You may be able to treat mild bruises or hematomas at home. Larger or internal hematomas may require medical care.

Bruises and Superficial Hematomas

Bruises may heal on their own, but may benefit from treatments like the RICE method (rest, ice, compression, and elevation).

This involves:

  • Rest and elevate the area where the bruise/hematoma is to minimize swelling and ease discomfort.
  • For the first day or two after the injury/trauma, apply a bag of frozen peas or an ice pack wrapped in a towel to the affected area for 10 to 15 minutes several times a day.
  • Gently compress the injured area with an elastic bandage if swelling is present.

Hematomas on the skin may benefit from a similar approach, although a splint may be advised to keep an injured limb from moving and prevent the larger vessel from breaking open again.

If needed, pain can be controlled with Tylenol (acetaminophen) rather than an NSAID like Advil (ibuprofen). NSAIDs promote bleeding and can make the condition worse.

Larger or Deeper Hematomas

Hematomas that are pressing on a nerve or blood vessel, or are causing tissue damage may require surgical drainage or removal. The drainage of any hematoma must be done before the blood clots and forms a solid mass.

In terms of skull hematomas:

  • Bed rest and observation may be all that is needed for small skull hematomas.
  • For large skull hematomas, a procedure known as burr hole surgery may be used to drill a hole in the skull in order to drain the trapped blood.
  • Severe cases may require a craniotomy, during which a piece of skull bone is temporarily removed to extract the trapped blood.

If surgery is done, a drain may be left in place for a couple of days while the individual is closely monitored in the hospital.

The treatment of internal hematomas elsewhere in the body may involve a watch-and-wait approach under observation or immediate surgical investigation.

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