Institutional members access full text with Ovid®

Share this article on:

Cylinder Syringe Suction: A Simple and Efficient Technique for the Evacuation of Subcutaneous Hematoma

Hayashi, Ayato MD*; Matsuda, Norifumi MD*; Horiguchi, Masatoshi MD*; Matsumura, Takashi MD*; Komoto, Masakazu MD*; Natori, Yuhei MD*; Komuro, Yuzo MD; Mizuno, Hiroshi MD*

Journal of Craniofacial Surgery: May 2013 - Volume 24 - Issue 3 - p 777–780
doi: 10.1097/SCS.0b013e318287d0db
Original Articles

Background Subcutaneous hematoma is commonly caused by trauma or surgery. Proper treatment of the condition is needed to avoid severe complications. The present paper introduces a simple technique of hematoma evacuation, called cylinder syringe suction (CSS). Experiments were also performed to determine the detailed mechanism underlying its effectiveness.

Methods The CSS procedure was performed as follows. A cylindrical plastic cylinder syringe was used. Either a few stitches were removed or a very small incision was made on the site of the hematoma. The edge of the syringe was compressed to the skin, which was covered by a thin hydrocolloid dressing. Vacuum aspiration was enforced at the site of the wound or incision, and the hematoma was gradually aspirated.

For the experiment, house rabbits were used. Hematoma evacuation was performed in 4 different ways, including needle aspiration alone (group 1), needle puncture followed by CSS (group 2), and creation of a small wound (5 mm) followed by needle aspiration (group 3) or CSS (group 4). The amount of evacuated hematoma and the suction pressure created by each of the 4 methods were compared.

Results Group 4 showed the highest suction pressure and the greatest evacuated amount of hematoma. High suction pressure was also obtained in group 1; however, the amount of evacuated hematoma was small as the other 2 groups.

Conclusion The CSS technique becomes effective mainly by creating high suction pressure, and the opening of a small wound enables the viscous coagula to pass through the skin.

Supplemental digital content is available in the article.

From the *Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo, and †Department of Plastic and Reconstructive Surgery, Juntendo University Urayasu Hospital, Chiba, Japan.

Received October 11, 2012.

Accepted for publication January 2, 2013.

Address correspondence and reprint requests to Ayato Hayashi, MD, Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan; E-mail:

The authors report no conflicts of interest.

This paper was presented at the 16th Congress of the International Confederation for Plastic Reconstructive and Aesthetic Surgery (IPRAS) meeting in Vancouver, 2011.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2013Wolters Kluwer Health | Lippincott Williams & Wilkins