Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
J Plast Reconstr Aesthet Surg. 2012 Nov;65(11):1589-91. doi: 10.1016/j.bjps.2012.03.046. Epub 2012 May 1.
A Morel-Lavallée lesion can occur after a closed degloving injury. It is a persistent seroma that may be resistant to conservative methods of treatment such as percutaneous drainage and compression therapy. We present a novel, successful method of surgical treatment.
A 70 year-old lady developed a 30 × 15 cm rapidly enlarging right medial thigh/knee swelling after being hit by a car. Conservative treatments failed, sarcoma was excluded, and the diagnosis confirmed, by MR imaging and cytology prior to referral. The lesion was excised, and blue dye lymphatic mapping used to identify and ligate feeding lymphatic vessels. The cavity was then closed using fibrin sealant spray and resorbable quilting sutures. A pressure garment was fitted.
The wound healed without complication, with no recurrence at six months. The patient returned to normal activities without pressure garments.
This method provides a novel, successful approach to the surgical treatment of a chronic Morel-Lavallée lesion.
闭合性撕脱伤后可发生 Morel-Lavallée 损伤。这是一种持续存在的血清肿，可能对经皮引流和压迫治疗等保守治疗方法有抗性。我们提出了一种新颖的、成功的手术治疗方法。
一位 70 岁的女士被汽车撞击后，右侧大腿/膝盖出现了一个 30×15cm 的迅速增大的肿胀。在转诊之前，通过磁共振成像和细胞学检查排除了肉瘤，并确诊为保守治疗失败的创伤性滑囊炎。对病变进行了切除，并使用蓝色染料淋巴示踪技术来识别和结扎供养淋巴管。然后使用纤维蛋白密封喷雾和可吸收缝合线闭合腔。随后穿上压力衣。
伤口愈合良好，无并发症，六个月内无复发。患者无需穿压力衣即可恢复正常活动。
这种方法为慢性 Morel-Lavallée 损伤的手术治疗提供了一种新颖的、成功的方法。
