Morel-Lavallée Lesion Treated With Single-Use Portable Negative Pressure Wound Therapy: A Case Report and Literature Review

TL;DR

A patient with a missed Morel-Lavallée lesion in the thigh was successfully treated with portable negative pressure wound therapy over two months.

Contribution

This case report highlights the effective use of single-use portable NPWT for treating an isolated Morel-Lavallée lesion.

Findings

The patient's wound stabilized after two months of portable NPWT.

The lesion was initially misdiagnosed on admission.

Minor interventions like drainage and debridement were used alongside NPWT.

Abstract

A Morel-Lavallée lesion (MLL) is a traumatic, internal closed degloving injury that results from the shearing of the subcutaneous tissue away from the underlying fascia, usually associated with high-velocity trauma.

A 52-year-old man was transported to our hospital for further follow-up of a superficial femoral artery injury. Examination on admission showed bruising seen around the left thigh. Contrast-enhanced computed tomography of the left thigh revealed a hematoma with extravasation from a branch of the left superficial femoral artery, but no apparent aneurysms or femoral fractures. The patient was treated with compression bandages and discharged on hospital day 6. He left the hospital able to walk unaided. He subsequently complained of left thigh pain with swelling and visited the hospital several times. He was treated at another outpatient clinic and was diagnosed with MLL. Single-use disposable portable negative pressure wound therapy (NPWT) was applied for about two months, achieving a stable wound site.

We encountered a case of MLL successfully treated with single-use portable NPWT. This report presents the case of a patient with isolated MLL without fracture in the left thigh, in which the diagnosis was missed on initial admission. Finally, the patient received minor interventions including drainage along with tissue debridement and portable NPWT. We reviewed the relevant literature and summarized the pathogenesis, clinical manifestations, and treatment strategies for MLL. Emergency physicians require an increased understanding of MLL to avoid misdiagnosis and missed diagnosis.

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