Surgical Management of Perigraft Seroma by Graft Wrapping with Local Hemostatic Agents: A Case Report

A 76-year-old female developed progressive local groin bulging. She received regular hemodialysis using a left-thigh polytetrafluoroethylene arteriovenous graft in the loop configuration. Lower extremity enhanced computed tomography showed a large low-density area around the graft 18 months after its creation, and perigraft seroma (PS) was suspected. The patient underwent PS excision followed by graft wrapping with two local hemostatic agents, oxidized regenerated cellulose, and a fibrin sealant. Local PS recurrence was not detected four months after surgery. We herein describe a surgical case of refractory PS successfully treated by graft wrapping using two local hemostatic agents.