The Mayo Clinic experience with Morel-Lavallée lesions

Nickerson, Terry P.; Zielinski, Martin D.; Jenkins, Donald H.; Schiller, Henry J.

doi:10.1097/ta.0000000000000111

Cited by 130 publications

(125 citation statements)

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“…Active arterial extravasation is noted in less than 1/3 of cases [13]; therefore, the evolution and continued drainage of hemolymphatic fluid increases radiologic accuracy over time. The average measurement of Hounsfield units (HU) reflect the internal contents of MLLs varying based on age: acute 30 HU, subacute 16 HU, and chronic 6 HU [14]. …”

Section: Discussionmentioning

confidence: 99%

“…The natural history of MLL has yet to be completely described [14] but are typically classified into three different subtypes based on imaging: seroma, subacute hematoma, and chronic hematoma. The genesis of the fluid accumulation is typically from disruption of blood vessels and lymphatics in the subcutaneous space overlying the fascia of the muscle.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic fluid accumulation can then become infected and turn into an acute abscess or encapsulated by a fibrous capsule over time if the collection remains sterile. Ultimately, the discovery and diagnosis of MLL is based on several factors, including skin mobility, subcutaneous fluctuation, decreased cutaneous sensation, tire marks, and friction burns [14]. …”

Section: Discussionmentioning

confidence: 99%

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A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall

Brown

Chang

et al. 2018

Burns &Amp; Trauma

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BackgroundMorel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients.Case presentationWe present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL. The internal degloving caused significant devascularization of the overlying soft tissue and skin which required surgical drainage of hematoma, abdominal wall reconstruction with tangential excision, allografting, negative pressure wound therapy, and ultimately autografting.ConclusionMLL is a rare, often overlooked, internal degloving injury. Surgeons must maintain a high index of suspicion when dealing with third degree friction burns as they may mask underlying injuries such as MLL, and a delay in diagnosis can lead to increased morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall

Brown

Chang

et al. 2018

Burns &Amp; Trauma

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show abstract

“…Lesions can be overlooked during initial presentation in the setting of more serious acute injuries or missed due to a low index of suspicion. 2,3 However, this patient's presentation has unique characteristics not described in classic Morel-Lavallé e lesions. Classic clinical presentation usually involves a combination of swelling, bruising, fluctuant overlying skin, tenderness, and skin contour asymmetry.…”

Section: 3mentioning

confidence: 97%

“…Classic clinical presentation usually involves a combination of swelling, bruising, fluctuant overlying skin, tenderness, and skin contour asymmetry. [2][3][4] Recent case reports of Morel-Lavallé e lesions involving the distal thigh, pre-patellar region, and pelvis have described lesions mainly presenting with swelling or evidence of ecchymosis. [5][6][7] The patient described here presented with a large fungating mass and overlying skin ulceration.…”

Section: 3mentioning

confidence: 99%