What are the best methods for achieving scrotal haemostasis?
Early this afternoon I carried out a tidy excision of scrotal hydrocoele, minimal bleeding, careful inspection of cut hydrocoele edge, oversewing with 4/0 chromic catgut, bipolar for small bleeders, original transverse scrotal incision with s-l-o-w cutting diathermy, careful closure in 4 layers with subcuticular to close.
4 hours later there is a diffuse unsightly haematoma of the scrotum, like previous ones I have explored and found no discrete collection to evacuate and no specific bleeder to tie off or buzz.
The following methods haven't seemed to help:
Hitch stitch [single large suture of fundus of scrotum to lower abo wall for 24 hours]
Unicorn [taking up spare scrotal skin into a "unicorn" with light tape]