Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review

Gardner, Preston; Flis, Diana M; Chaiyasate, Kongkrit

doi:10.1155/2017/8120587

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…The goal in that case report was to fix overlying contour deformity due to scar contracture. This differs from the goal in our case report, which was to prevent tissue ischemia due to pressure from hematoma formation [7]. Another lower extremity case report utilized liposuction to treat a subacute (three weeks prior) MLL of the left lateral thigh with capsule formation [8].…”

Section: Figure 3: Three-month Post-operative Photo Discussionmentioning

confidence: 83%

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Novel Use of a Closed Liposuction System: Treatment of an Acute Morel-Lavallée Lesion of the Upper Extremity

Wee

Kumar³

et al. 2020

Cureus

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Morel-Lavallée lesions (MLL) are closed post-traumatic soft tissue shear injuries that occur between fascial planes and may result in tissue loss. Current treatment options for MLL include percutaneous drainage and open irrigation and debridement. A few cases of suction-assisted lipectomy (SAL) have been described for subacute and chronic MLL of the lower extremity. We present the first case report of using a closed SAL system to treat an acute MLL of the upper extremity. A 78-year-old female with right forearm MLL presented after blunt force trauma while on apixaban. After inpatient monitoring and anticoagulant drug clearance, a closed system SAL was performed to evacuate the hematoma and prevent ischemia of overlying soft tissues. Treatment outcomes were measured by clinical exam and CT imaging. Pre-operative diagnostic CT scan demonstrated a 4.8 x 6.6 x 13 cm fluid collection between fascial layers of the right forearm. SAL resulted in the evacuation of 300 cc of coagulated blood. Post-operative CT imaging of the right upper extremity did not show any measurable fluid collection. Clinical exam demonstrated resolution of swelling and soft tissue compromise. The patient reported significant pain reduction, resumed her anticoagulation, and was discharged home. There were no notable complications at her three month post-operative visit. Consideration of a constant low-pressure SAL system can successfully treat MLL in the acute period. This system is relatively minimally invasive, results in faster healing times compared to open debridement, and still results in effective hematoma evacuation.

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Section: Figure 3: Three-month Post-operative Photo Discussionmentioning

confidence: 83%

“…Novel treatments, such as doxycycline-induced sclerodesis, have been shown to be successful in persistent lesions [6]. A few cases of suction-assisted lipectomy (SAL) have also been described in the literature, but only in the case of chronic lesions of the lower extremity [7].…”

Section: Introductionmentioning

confidence: 99%

Novel Use of a Closed Liposuction System: Treatment of an Acute Morel-Lavallée Lesion of the Upper Extremity

Wee

Kumar³

et al. 2020

Cureus

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“…51 Liposuction has also been used to improve the appearance and contour of the surrounding soft tissue. 52 …”

Section: Discussionmentioning

confidence: 99%

“…51 Liposuction has also been used to improve the appearance and contour of the surrounding soft tissue. 52 Video-assisted endoscopic debridement is another technique that allows for direct visualization and excision of a capsule. Endoscopic debridement has also been combined with percutaneous cutaneo-fascial sutures to reinforce closure of dead space.…”

Section: Surgicalmentioning

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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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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“… 6 , 21 Conservative treatment options for acute lesions include compression bandaging and rest, with or without repeat aspiration. 6 , 22 Surgical options include debridement of necrotic fat and capsular resection (via open or minimally invasive techniques, 23 -– 27 with adjunctive use of quilting sutures, 28 sclerosing agents, 2 , 29 , 30 or synthetic or fibrin glue application 12 , 31 , 32 ). In chronic cases, surgical intervention has been shown to be more successful than conservative therapy, with recurrence related to non-compliance with compressive dressings post-treatment.…”

Section: Discussionmentioning

confidence: 99%

Morel-Lavallée lesions: a phenomenon in cats? Case report and review of the literature

McGhie

Gibson

Herndon

2018

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 3-year-old male neutered domestic shorthair cat sustained a severe sacrococcygeal luxation post-motor vehicle trauma. Six days post-trauma, a fluid-filled swelling was noticed over the caudoventral abdomen and inguinal regions. Needle aspiration, closed suction drain placement and debridement with subcutaneous tacking were all attempted but failed to resolve the continued accumulation of serosanguinous lymphocyte-rich fluid in the subcutaneous pocket. Clinical resolution was ultimately achieved after surgical debridement and omentalisation of the lesion.Relevance and novel informationMorel-Lavallée lesions are post-trauma closed soft tissue degloving injuries described infrequently in people. The avulsion of subcutaneous tissue from deep muscle fascia results in the accumulation of haemolymph and necrotic fat, which can persist for several days to months after the inciting incident. In people, they are commonly seen in the proximal thigh. This article proposes the existence of Morel-Lavallée lesions in cats.

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Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review

Cited by 5 publications

References 26 publications

Novel Use of a Closed Liposuction System: Treatment of an Acute Morel-Lavallée Lesion of the Upper Extremity

Novel Use of a Closed Liposuction System: Treatment of an Acute Morel-Lavallée Lesion of the Upper Extremity

Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

Morel-Lavallée lesions: a phenomenon in cats? Case report and review of the literature

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