Unveiling the uncommon: vault hematoma and vault cellulitis following hysterectomy - a comprehensive narrative review

Hysterectomy is a common surgical procedure performed to remove the uterus. This is considered as a clean-contaminated surgical procedure. It is a safe procedure, but major and minor complications can occur, including vault hematoma and vault cellulitis, which are specific to the surgical site. Vault hematoma is the accumulation of blood within the vaginal vault, while vault cellulitis is an infection of the vaginal vault or the surgical cuff following a hysterectomy. Vault hematoma may be caused by trauma during surgery, improper hemostasis or infection. Smaller hematomas may resolve with conservative management, but larger vault hematomas and infected hematomas may need surgical drainage and antibiotic coverage. Vault cellulitis typically occurs due to the introduction of bacteria into the surgical site which may occur due to inappropriate postoperative care and contaminated materials. The patient may present with pelvic pain and fever. Broad-spectrum antibiotics are typically prescribed to treat the infection. While both these complications are relatively rare and appear to be mild, healthcare providers should be vigilant in recognizing and managing them promptly to prevent adverse outcomes. Prophylactic antibiotics should be administered before the surgery to reduce the risk of infection. Care should be taken to minimize tissue trauma, ensure proper hemostasis, and maintain strict aseptic techniques during surgery.