A Novel Surgical Technique for treatment of Morel-Lavallée Lesion: Endoscopic debridement combined with percutaneous cutaneo-fascial suture

Liu, Min; Liu, Liangle; Zhou, Xiaosai; Wu, Lijie; Wang, Juncheng; Li, Qi; Cai, Chun-Yuan

doi:10.1016/j.injury.2018.06.003

Cited by 17 publications

(21 citation statements)

References 14 publications

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“…This subcutaneous fluid mass is the result of tangential forces, shearing, rubbing or crushing injuries [1] with moderate to high kinetics [1,3] in an anatomical area with an underlying fascia. The most common areas affected are the great trochanters, buttocks, thighs, knees and lumbar spine [3,5]. In our clinical case, the MLL is more likely related to tangential impact of the hood of the car than rubbing after projection on the road.…”

Section: Morel-lavallée Lesion and Accountabilitymentioning

confidence: 62%

“…Scolaro et al [7] also estimate that a significant number of patients have a missed or delayed diagnosis because of distracting injuries in the polytraumatized or delayed superficial * * discolorations of the skin. Road crashes are the main cause of MLLs [1,5]. Sports requiring sliding actions (such as football, soccer, or baseball) rank second in order of frequency [8,9].…”

Section: Morel-lavallée Lesion and Accountabilitymentioning

confidence: 99%

“…Medico-legal evaluation of the functional consequences must consider (i) the pain intensity that may cause functional disability and (ii) the fluid volume of the lesion that may cause joint limitations and on which will also depend (iii) the therapeutic management. If the volume is estimated to be less than 50 mL, the first-line treatment is compression wraps, cryotherapy, non-steroidal anti-inflammatory drugs and physiotherapy [1,3,5,[12][13][14]. If the volume is greater than 50 mL, aspiration is fulfilled (with or without injection of sclerosing agents).…”

Section: Morel-lavallée Lesion and Temporary Functional Disabilitymentioning

confidence: 99%

“…However, in the event of recurrence despite repeated aspiration, surgical management, most often ambulatory, will be necessary (Ronceray's fasciotomy or endoscopic debridement combined with percutaneous cutaneo-fascial suture) [1,3,5,[12][13][14]. As routinely estimated in France, the duration of this functional disability for daily acts can be quantified on a scale called improperly 'Total Incapacity to Work' ('incapacité totale de travail', ITT) and is therefore generally greater than 8 days and less than 3 months.…”

Section: Morel-lavallée Lesion and Temporary Functional Disabilitymentioning

confidence: 99%

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Medico-legal considerations for Morel-Lavallée lesions

Scanvion

Garff

Gosset

et al. 2019

Forensic Sci Med Pathol

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The Morel-Lavallée lesion is an infrequent traumatic lesion that the forensic physician may need to evaluate during examination of a victim. Using a review of the literature and an illustrative case, the objective is to discuss the medico-legal issues (accountability, functional recovery and healing times, and aftermath) associated with Morel-Lavallée lesions. We describe the case of a 24-year-old motorcycle driver who was hit by a car. Clinically, the right lumbar region had a large 16×15 cm ecchymosis with subcutaneous fluid swelling found by palpation. A body scan revealed a Morel-Lavallée lesion among other lesions. On day 7, its thickness was decreased by half. Morel-Lavallée lesions are specifically induced by shearing force with moderate-to-high kinetics in an anatomical area with an underlying fascia. The associated functional disability is globally moderate, but a large lesion or recurrences can extend the time needed to recover. Apart from some exceptions, care without any delay in diagnosis and treatment allows evolution of the lesion without functional consequences, but these lesions are frequently unnoticed in the initial phase. Key points  The Morel-Lavallée lesion is an infrequent lesion, often missed in the initial phase, but should be known for medico-legal reports.  The Morel-Lavallée lesions are the result of a shearing force causing translational movement.  Road crashes are the main cause of Morel-Lavallée lesions and sports requiring sliding actions rank second in order of frequency.  Its functional disability is globally moderate, but a large lesion or recurrences can increase the time of resolution of the disability.

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Section: Morel-lavallée Lesion and Accountabilitymentioning

confidence: 62%

Section: Morel-lavallée Lesion and Accountabilitymentioning

confidence: 99%

Section: Morel-lavallée Lesion and Temporary Functional Disabilitymentioning

confidence: 99%

Section: Morel-lavallée Lesion and Temporary Functional Disabilitymentioning

confidence: 99%

See 2 more Smart Citations

Medico-legal considerations for Morel-Lavallée lesions

Scanvion

Garff

Gosset

et al. 2019

Forensic Sci Med Pathol

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“…This technique has been used in patients with comorbidities that preclude open debridement and drainage, and may also be better suited to those requiring expedited recovery such as young athletes. 8 , 47 , 53 …”

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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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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