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

Mid-term prognosis of endoscopic debridement combined with percutaneous cutaneo-fascial suture for the treatment of Morel-Lavallée lesion: a minimum 3-year follow-up study

PURPOSE

Morel-Lavallée lesion (MLL) is a closed soft-tissue degloving injurie resulting from shear forces. With the advent of endoscopic technology and advancements in surgical techniques, innovative solutions are now available. However, there are few data on mid-term results after treatment of MLL, especially regarding arthroscopic method. The objective of this study is to evaluate the clinical outcomes of endoscopic debridement combined with percutaneous cutaneo-fascial suture in treating MLL.

METHODS

A single-center retrospective study was conducted at a university teaching hospital investigating patients who underwent arthroscopic management of Morel-Lavallée lesion between 2014 and 2020.Patient demographics, postoperative recovery time, peri- and postoperative complications were investigated. Mid-term follow up clinical and radiological examinations were performed.

RESULTS

The retrospective study included 38 patients aged between 11 and 90 years, with an average age of 50.9 ± 16.9 years. These patients waited an average of 36.6±23.5days to return to work after operation. The average time to follow-up was from 3 to 9 years, averaging 5.0 ± 1.8 years. At the end of follow-up, only one complication of superficial skin necrosis occurred, accounting for 2.6%. The imaging assessment at the final follow-up indicated improvement over the postoperative period for all 38patients.

CONCLUSION

In mid-term experience, endoscopic debridement combined with percutaneous cutaneo-fascial suture for MLL management is a safe and effective option.

A case report of severe unstable pelvic fracture with extensive perineal destruction and Morel-Lavallee lesion, with literature review

INTRODUCTION AND IMPORTANCE

Unstable pelvic fractures in children are mainly caused by high-impact injuries, which are often combined with multiple injuries. A rare type of degloving injury named Morel-Lavallee lesion (MLL) is easily overlooked in obese children.

CASE PRESENTATION

A case of unstable pelvic fracture combined with extensive perineal injury and MLL in an obese child was discussed. The general conditions, diagnosis, and treatment were summarized.

CLINICAL DISCUSSION

Unstable pelvic fractures are associated with extremely high disability and mortality rates and are often associated with hemorrhagic shock, urethral injury, or lower-extremity dysfunction. Clinicians need to be more alert to the possibility of MLL in obese children.

CONCLUSION

Multidisciplinary diagnosis and treatment with individualized surgical procedures are key to a good prognosis.

The Morel-Lavallée Lesion: Review and Update on Diagnosis and Management

Morel-Lavallée lesion is a closed soft tissue degloving injury usually associated with high-velocity trauma. It most commonly occurs in the thigh, hip, and pelvis. Because such lesions are prone to a missed or delayed diagnosis, it may present a potential risk of infection at the fracture site once it progresses. Therefore, timely identification and management of Morel-Lavallée lesion is crucial. Moreover, there are no relevant guidelines for the treatment of Morel-Lavallée lesion. Based on the above facts, we reviewed the etiology, epidemiology, pathophysiology, clinical presentation, imaging features, treatment, prognosis, and complications of Morel-Lavallée lesion with the aim of providing a comprehensive overview of Morel-Lavallée lesion, increasing awareness of this injury among orthopaedic surgeons, and thus providing a management algorithm that can be applied to this injury.

Practical Review of the Comprehensive Management of Morel-Lavallée Lesions

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.

Morel-Lavallée Lesion with Friction Burn: Management Using Veraflo Vac Dressing, Preserving Body Contour

While the standard of care for subcutaneous degloving injuries (Morel Lavallee lesion) in conjunction with friction burns is drainage, wide excision and grafting, this case was treated with drainage and continuous lavage with the help of the noncompressible Veraflo Vac dressing. This led to rapid reattachment of the tissues and preservation of body contour long term.