The Morel-Lavallée lesion and its management: A review of the literature

Abstract

Our algorithm recommends avoidance of conservative management. For chronic lesions, percutaneous aspiration should not be used in isolation. Sclerodesis using doxycycline is appropriate for lesions up to 400 ml, where evidence suggests high degrees of efficacy. Larger lesions should be treated with open surgery. Quilting sutures, curettage and low suction drains are useful adjuncts. We hypothesise this algorithm would also be effective for post-operative seromas.

Morel-Lavallée Lesion Following a Low-speed Injury: A Case Report

“…5 Following disruption of the fascial layer, transaponeurotic capillaries and lymphatic vessels become disrupted and leak haemolymphatic fluids into the newly formed cavity. 6 Over time, blood is reabsorbed and replaced with serosanguinous fluids, which can cause a sustained inflammatory response and the formation of a cystic mass. 5 Although the exact epidemiology is unknown, the majority of Morel-Lavallée injuries are seen in those with a body mass index of or more following trauma with a high-energy mechanism.…”

“…5 Although the exact epidemiology is unknown, the majority of Morel-Lavallée injuries are seen in those with a body mass index of or more following trauma with a high-energy mechanism. 5,6 Upon initial ED presentation, a patient may have soft tissue swelling with or without ecchymosis, skin contour asymmetry with hypermobility, or a soft tissue fluctuance with minimal or no tenderness. 5,6 Given many of these injuries do not become apparent until after the initial injury, patients may also present in a delayed fashion with decreased sensation, necrosis, and color changes over the lesion.…”

“…5,6 Upon initial ED presentation, a patient may have soft tissue swelling with or without ecchymosis, skin contour asymmetry with hypermobility, or a soft tissue fluctuance with minimal or no tenderness. 5,6 Given many of these injuries do not become apparent until after the initial injury, patients may also present in a delayed fashion with decreased sensation, necrosis, and color changes over the lesion. 5,6 Magnetic resonance imaging is currently the imaging modality of choice due to its high-contrast resolution, multiplanar image acquisition, and enhanced anatomical details as compared to other modalities.…”

“…5,6 Given many of these injuries do not become apparent until after the initial injury, patients may also present in a delayed fashion with decreased sensation, necrosis, and color changes over the lesion. 5,6 Magnetic resonance imaging is currently the imaging modality of choice due to its high-contrast resolution, multiplanar image acquisition, and enhanced anatomical details as compared to other modalities. 2 Computed tomography is another diagnostic modality that can be used because of its availability in the trauma setting but does not easily allow for the characterization of soft tissue injuries.…”

Morel-Lavallee Lesions: A Non-Operative Case Series

“…As with choice of imaging, a range of options exists for treatment of these lesions [11]. These options include conservative treatment with compressive wrap, percutaneous drainage, injection of sclerosing agents such as talc and doxycycline, closed surgical drainage, and for chronic lesions that have developed capsules, complete surgical excision of the lesion.…”