Posttraumatic Morel-Lavallée seroma – clinic and forensic implications

Abstract

The posttraumatic Morel-Lavallée seroma (MLS) completes, in medico-legal traumatology, the group of closed soft tissue injuries, along with the bruise, the hematoma and the muscular contusion. It is defined as a closed soft tissue injury produced most commonly as a result of direct trauma with tangential impact, followed by the shearing of the hypodermis from the underlying fascia, which results in a cavity filled with blood, lymph and both viable and necrotic fatty tissue. It can be seen in association with pelvic trauma, typically in the region of the hip, the thigh, the lower lumbar aria, the gluteal area and the abdominal wall. Studies and articles on the subject are scarce in the medical literature in general, and even more so in the medico-legal one, although the problems it raises are complex. The present paper starts with an updated presentation of the MLS clinical aspects, followed by an analysis of the medico-legal implications with regard both to the interpretation of MLS injury mechanisms, and to the medico-legal criteria for the evaluation of diagnostic accuracy, evolution and complications for this post-traumatic entity that often has a prolonged trajectory, marked by repeated medical and surgical interventions and multiple medico-legal evaluations. Hence, an indirect change in the medico-legal interpretation of the severity of this initially benign type of injury can appear. Difficulties in establishing the causal link between the initial trauma and certain belated complications may also occur.

The Morel-Lavallee lesion: a review and a proposed algorithmic approach

“…The fluid in MLL is considered sterile in the absence of obvious signs of infection. Occasionally positive cultures are obtained from MLL [22,23].…”

Surgical Treatment of a Delayed Diagnosed Morel-Lavallee lesion: A Case Report

“…Closed degloving injury, also known as Morel-Lavallee lesion, are soft-tissue injuries caused by a sudden and strong shearing force that damages the underlying fascia, and area between the skin and subcutaneous tissue [1,2]. These types of lesions are usually caused by post-traumatic soft-tissue injuries and their incidence is rare [3,4].…”