Seat belt Morel-Lavallée seroma

Dallaudière, B.; Desportes, E.; Pommier, Rodney F.; Clark, Andrea; Loriaut, P.; Serfaty, Jean Michel

doi:10.1016/j.diii.2015.06.015

Cited by 8 publications

(13 citation statements)

References 6 publications

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“…MLLs in the calf, abdominal wall, proximal upper extremity, lumbar spine, scalp, periscapular, and sacrococcygeal regions are also described. 16–20…”

Section: Discussionmentioning

confidence: 99%

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Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

Molina

Ghazoul

Janis

2021

Plastic and Reconstructive Surgery - Global Open

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Background: Morel-Lavallée lesions have been described in the literature since the mid-19th century, yet contemporary clinical management continues to be challenging and remains variable. These closed degloving injuries are usually seen in the setting of blunt trauma and are due to shearing forces, creating a space for the collection of hemolymphatic fluid. These fluid collections can be persistent despite conservative treatment attempts and can require staged surgical interventions. Methods: A literature search of peer-reviewed articles pertaining to Morel-Lavallée lesions was performed. Articles relating to the pathophysiology, clinical presentation, diagnosis, treatment, and management of complications of Morel-Lavallée lesions were included to formulate recommendations for clinical management. Results: Fifty-six relevant articles were included in the review. Recognition of these lesions may be delayed and the use of imaging is important in diagnosis. Initial attempts at conservative management may be appropriate for smaller, uncomplicated Morel-Lavallée lesions. Surgical interventions such as open debridement, techniques to close dead space, negative pressure wound therapy, and skin grafts or flaps are critical to managing complex or recurring lesions. An algorithm for the treatment of Morel-Lavallée lesions is proposed based on review of the literature. Conclusions: Plastic and reconstructive surgeons are frequently involved in more complex Morel-Lavallée lesions such as those exhibiting delayed healing or super-infection. The skillset needed for successful management of patients with Morel-Lavallée lesions is well within the armamentarium of plastic and reconstructive surgeons.

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“…MLLs in the calf, abdominal wall, proximal upper extremity, lumbar spine, scalp, periscapular, and sacrococcygeal regions are also described. 16–20…”

Section: Discussionmentioning

confidence: 99%

“…32–35 Compression garments serve as an adjunct after aspiration to prevent re-accumulation of fluid. 17…”

Section: Discussionmentioning

confidence: 99%

Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

Molina

Ghazoul

Janis

2021

Plastic and Reconstructive Surgery - Global Open

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“…MLLは，外傷後の閉鎖性デグロービング軟部組織損傷であり，1863年にフランスの外科医Morel–Lavalléeによって最初に報告された 3), 4), 5)。病変は，強い剪断応力によって引き起こされ，可動性を有する表在性皮下組織が硬い下層筋膜から剥がれてできた潜在的なスペースに，損傷した小血管およびリンパ管から血液，リンパ液，壊死性脂肪組織が溜まり，患部に腫脹として現れる 3), 4), 5)。主な原因は高エネルギー外傷で，自動車事故が25%を占める 6)が，フットボールやレスリングなどのスポーツ傷害でも発症する 5), 7)。我々の調べた限りでは，シートベルトによるMLLの報告はこれまでにDallaudièreら 8)とHeoら 9)の2例のみであり，本邦では本症例が初の報告である。…”

Section: 考　　察unclassified

シートベルト損傷によるMorel–Lavallée lesionの1症例(A case of Morel–Lavallée lesion due to seatbelt injury)

普至¹,

権一²,

元洋³

et al. 2021

Nihon Kyukyu Igakukai Zasshi: Japanese Journal of Japanese Asso

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要旨　Morel–Lavallée lesion（以下，MLL）は，高エネルギー外傷後にみられる閉鎖性デグロービング損傷で，血液，リンパ液，壊死性脂肪で満たされた空洞を形成する稀な疾患である。今回，本邦では未だ報告のないシートベルト外傷によるMLLの1例を経験したので報告する。症例は60代の男性。自動車運転中に電柱に衝突し受傷した。来院時，前縦隔に血腫を伴う胸骨骨折，右下腹壁動脈分枝損傷を伴う右鼠径部の皮下血腫，左多発肋骨骨折，右鎖骨骨折を認め，右下腹壁動脈分枝と左内胸動脈分枝に経皮的動脈塞栓術を施行した。右鼠径部の皮下血腫は消退し，第3病日にfollow upの胸腹部CTを施行したが新たな異常所見はなく，リハビリテーションを強化した。第6病日に両鼠径部に新たな皮下血腫が出現し，第7病日のCTでは両鼠径部に液面形成を伴った液体貯留を認めた。MLLと診断し，第8病日に血腫除去・ドレナージ・洗浄を行った。入院経過中に急性胆嚢炎を合併し胆嚢摘出術を施行したが，その後の経過は良好で，第48病日に独歩で自宅退院した。本症例は，シートベルトによる強い剪断応力により両鼠径部にMLLを発症したと考えられた。

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“…This progressively growing fibrous capsule may lead to complications such as recurrence, secondary infection, skin necrosis, neurovascular compromise, as well as chronic pain [ 3 ]. A Morel-Lavallee lesion is primarily a clinical diagnosis, but imaging modalities help to further characterize the lesion and to rule out other competing diagnoses [ 7 ]. Although CT may be used in the initial evaluation of these lesions due to its ease and availability in the emergent setting, MRI is considered the imaging modality of choice [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Morel-Lavallee Lesion: A Case of Lower Extremity Internal Degloving Injury

Durrani¹,

Milas²,

Osmolinski³

et al. 2023

Cureus

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A 22-year-old female patient was seen in the emergency department with a two-week onset of progressively worsening pain and swelling to the medial aspect of her distal left femur. The patient was involved in an automobile versus pedestrian accident two months prior sustaining superficial swelling, tenderness, and bruising to the affected area. Radiographs revealed soft tissue swelling without osseous abnormalities. Examination of the distal femur region revealed a large, tender, ovoid area of fluctuance with a dark crusted lesion and surrounding erythema. Bedside ultrasonography revealed a large anechoic fluid collection in the deep subcutaneous plane with mobile internal echogenic debris which was suspicious for a Morel-Lavallee lesion. The patient underwent contrast enhanced CT of the affected lower extremity demonstrating a 8.7 cm x 4.1 cm x 11.1 cm fluid collection superficial to the deep fascia of the distal posteromedial left femur, confirming the diagnosis of a Morel-Lavallee lesion. A Morel-Lavallee lesion is a rare, post-traumatic degloving injury that results in the separation of the skin and subcutaneous tissues from the underlying fascial plane. The resultant disruption of the lymphatic vessels and underlying vasculature leads to progressively worsening hemolymph accumulation. If not recognized and treated in the acute or subacute period, complications can ensue. Complications of Morel-Lavallee include recurrence, infection, skin necrosis, neurovascular injury, as well as chronic pain. Treatment is based on the size of the lesion and ranges from conservative management and surveillance for small lesions to percutaneous drainage as well as debridement, sclerosing agents, and surgical fascial fenestration approaches for larger lesions. Additionally, the utilization of point-of-care ultrasonography can help in the early identification of this disease process. This is important as a delay in diagnosis and subsequent treatment of this disease state is associated with long-term complications.

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Seat belt Morel-Lavallée seroma

Cited by 8 publications

References 6 publications

Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

シートベルト損傷によるMorel–Lavallée lesionの1症例(A case of Morel–Lavallée lesion due to seatbelt injury)

Morel-Lavallee Lesion: A Case of Lower Extremity Internal Degloving Injury

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