Morel-Lavallee lesions. Size matters? Treatment and time of disability

Rodríguez-Roiz, Dr Juan M; Burillo, Dr Jordi Montañana; Díaz, Dr José Simón Sanchez

doi:10.1016/j.injury.2022.10.023

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Early diagnosis of MLL is crucial for successful treatment and avoids late complications such as infection or skin necrosis. However, it can be diagnosed months or even years after trauma with only swelling or contour abnormalities [2,9,16]. Lesions diagnosed in the first 3 weeks are considered acute MLLs, and those diagnosed after 3 weeks are considered chronic MLLs [10].…”

Section: Resultsmentioning

confidence: 99%

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Vacuum-assisted surgical treatment of large and complex Morel-Lavallée lesions in lower extremities

Evin

2023

j-ebr

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Morel-Lavallée lesion (MLL) is the separation of the skin from the deep fascia caused by shear stress after trauma and the formation of a fluid-filled cavity between the fascia layers. After the inflammation develops, a fibrous capsule develops around the serosanguineous fluid, preventing its absorption. Cavity infection, skin necrosis, and muscle, tendon, bone, and implant exposure were observed in untreated MLLs. This study presents vacuum-assisted surgical treatment for large and complex MLLs and the effects of treatment on the functionality of lower extremities. Methods: 23 patients who were diagnosed with post-traumatic MLL in the lower extremities and underwent vacuum-assisted surgical treatment were examined. Demographic characteristics, comorbidities, smoking status, body mass index (BMI), type of trauma, anatomical location, skin characteristics of the cavity, additional injuries, duration of treatment delay, medical and surgical procedures, return to work, and social life were investigated. All cavities were evaluated using ultrasonography, and cavity volumes were measured. All patients underwent percutaneous incision drainage and radical debridement of necrotic tissues and cavities. Lower extremity function was evaluated using the lower extremity functional scale (LEFS). Results: A total of 82.6% of patients had chronic MLLs. All patients had high-volume MLLs and functional impairment due to MMLs. The vacuum-assisted wound closure provided compression, drainage, and obliteration of the cavity alone in the treatment of MLL. Additionally, the positive effects of negativepressure wound therapy (NPWT) on wound healing prevented complications such as recurrent MLLs, seroma, dehiscence, and graft loss. This method has also positively affected lower-extremity functionality during subsequent periods (p<0.001). Conclusions: In treating large-volume acute and chronic MLLs, percutaneous drainage, radical debridement, cavity closure with quilting sutures, and pressure support with NPWT are reliable methods that ensure problem-free healing of MLLs. This method has also positively affected lower-extremity functionality during subsequent periods.

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Section: Resultsmentioning

confidence: 99%

“…Various treatment methods have been suggested; however, no universal consensus exists [17,9]. Acute and small-volume (<50 mL) MLLs benefit from conservative treatments, such as compression bandages, anti-inflammatory therapy, physiotherapy, and rest [3].…”

Section: Introductionmentioning

confidence: 99%

Vacuum-assisted surgical treatment of large and complex Morel-Lavallée lesions in lower extremities

Evin

2023

j-ebr

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“…Hudson et al (1996) in a single-center study reported that only one out of seven patients had their MLLs recognized on initial presentation following acute injury, while the remaining cases were initially overlooked [ 12 ]. Another study by Rodriguez-Roiz et al (2022) involving nine patients found an average delay of 11.9 days before MLLs were identified after the initial injury [ 13 ]. Many of these patients had concurrent distracting injuries, likely contributing to the initial oversight.…”

Section: Discussionmentioning

confidence: 99%

“…(2022) involving nine patients found an average delay of 11.9 days before MLLs were identified after the initial injury [13]. Many of these patients had concurrent distracting injuries, likely contributing to the initial oversight.…”

Section: Table 2: Morel-lavallée Lesion Complicated By Pseudomonas Ae...mentioning

confidence: 99%

A Rare Case of a Morel-Lavallée Lesion Complicated by Pseudomonas aeruginosa Infection: Diagnostic Challenges and Therapeutic Considerations

Yousaf,

Hock,

Heh

et al. 2023

Cureus

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Morel-Lavallée lesions are uncommon soft tissue injuries resulting from trauma, characterized by the separation of subcutaneous tissue from the underlying fascia. Soft tissue infections with Pseudomonas aeruginosa are rare and most typically associated with hospital-acquired infections and burn wounds. This case report is regarding a 57-year-old man following a motorcycle accident who presented with a unique occurrence of an MLL complicated by P. aeruginosa infection. The patient underwent extensive treatment over the course of months, which may have been prevented with a better understanding of the injury. This case is noteworthy due to the infrequency of the injury, the pathogen, and concomitant occurrence, presenting a diagnostic and therapeutic challenge. We describe the patient's clinical presentation, hospital course, diagnostic workup, and management to inform future care and recognition of similar patients.

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“…The formation of a long hematoma will lead to secondary fat liquefaction necrosis, and eventually the production of false bursae. This pseudobursae is lled with low coagulation, high molecular weight, thin lymphatic uid, which interferes with self-absorption after injury, further leading to local soft tissue necrosis and an increased incidence of later infection [5][6][7] . Open injury associated with MLL further increases the probability of postoperative infection, necrosis and non-healing at the injured site.…”

Section: Discussmentioning

confidence: 99%

Morel-Lavallee Injury of Thigh Combined with Open Tibia-Fibula Fracture Treated by Combination of Traditional Chinese and Western Medicine ： A Case Report Study

Wang

Liu

2023

Preprint

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Background Morel-lavallee injury is a kind of closed soft tissue detroculation injury. This kind of injury is caused by high energy violence (including traffic accidents and serious mechanical crushing injury). It is one of the most common clinical injuries.In recent years, such injuries caused by various reasons show an increasing trend year by year. Purpose In this paper, a case of Morel-Lavallee injury of thigh combined with open fracture of tibia and fibula was reported recently. Combined with the experience in this treatment process, it is expected to provide reference for clinical diagnosis and treatment. Case report We report a 56-year-old middle-aged and elderly male patient who was admitted to hospital due to bleeding, malformation, swelling and pain of the right calf and restriction of movement for 7 hours due to accidental injury.The patient showed signs of shock and coma before admission. After resuscitation, the patient was admitted to our department from the emergency department with "open fracture of the lower end of the right tibia".Later, it was found that the right thigh was closed and ungloved, and surgery was recommended.After obtaining the consent of the patient and his family, he was hospitalized for surgical treatment in the orthopaedic Trauma Department of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine. Results Through this diagnosis and treatment, the patient's condition was controlled, the affected limb recovered well after the operation, and the function, blood circulation and sensation of the affected limb recovered well. Conclusion The combination of traditional and traditional Chinese and western medicine can promote the recovery of the affected limb better and faster, and reduce the occurrence of complications, which is beneficial to the patients.

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Morel-Lavallee lesions. Size matters? Treatment and time of disability

Cited by 8 publications

References 15 publications

Vacuum-assisted surgical treatment of large and complex Morel-Lavallée lesions in lower extremities

Vacuum-assisted surgical treatment of large and complex Morel-Lavallée lesions in lower extremities

A Rare Case of a Morel-Lavallée Lesion Complicated by Pseudomonas aeruginosa Infection: Diagnostic Challenges and Therapeutic Considerations

Morel-Lavallee Injury of Thigh Combined with Open Tibia-Fibula Fracture Treated by Combination of Traditional Chinese and Western Medicine ： A Case Report Study

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