Which of the following is a risk factor for hematoma formation due to poor hemostasis?

• A. Failure to establish adequate hemostasis
• B. Good elimination of dead space
• C. Immediate closure without regard to wound tension
• D. Use of pressure dressing

Answer: (A)

Hematoma formation occurs when bleeding continues after a wound is closed because the vessels weren’t properly sealed. The essential factor here is achieving adequate hemostasis during the procedure. If hemostasis isn’t established, blood can accumulate in the tissue planes, especially where there’s space to collect fluid, leading to a hematoma. That direct connection to stopping bleeding makes this the primary risk factor.

Protective measures that reduce risk include eliminating dead space, applying a compression or pressure dressing, and closing the wound with attention to tissue tension so that bleeding is less likely and any small oozing can drain properly. The other options describe practices that help prevent hematoma rather than create it, or address aspects other than the hemostasis itself.