Morel-Lavallée lesion: What you need to know
Nikta Sarani1, Amandeep Ahluwalia, Anna Buchanan
1From the Department of Surgery, Center for Trauma and Critical Care, George Washington University, Washington, DC.
Abstract:
The Morel-Lavallée lesion (MLL) is a rare closed degloving injury resulting from traumatic shearing forces that separate subcutaneous tissue from underlying fascia, creating a cavity filled with blood, lymph, and inflammatory exudate. Typically occurring in regions where skin can glide significantly over rigid structures, such as the thigh, MLLs present as fluctuant, boggy, sometimes painful lesions, which result from disrupted lymphatic and vascular structures. The lesion evolves through an inflammatory cascade leading to eventual encapsulation by dense fibrotic tissue. While the diagnosis is primarily clinical, imaging, particularly magnetic resonance imaging, assists in confirming lesion presence, assessing chronicity, and differentiating MLLs from other pathologies such as bursitis, hematomas, and sarcomas. Treatment strategies range from conservative approaches, including compression and aspiration for smaller lesions, progressing to minimally invasive procedures, such as percutaneous drainage and sclerotherapy, to operative intervention involving open drainage and debridement for larger, recurrent, or infected collections. Future advancements in standardized treatment guidelines, novel imaging modalities, and multidisciplinary rehabilitation are crucial for improving early recognition, therapeutic outcomes, and minimizing morbidity associated with MLLs.
Level Of Evidence:
Systematic review; Level I.


