Document Detail


Doxycycline sclerodesis as a treatment option for persistent Morel-Lavallée lesions.
MedLine Citation:
PMID:  22204771     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Morel-Lavallée lesion is a rare cause of subcutaneous swelling, caused by post-traumatic shearing of the hypodermis from the underlying fascia. Treatment of such lesions is still not well established. OBJECTIVE: To evaluate the results of conservative treatment for these lesions using doxycycline induced sclerodesis followed by elastic compression bandaging. PATIENTS AND METHODS: We treated 16 Morel-Lavallée lesions between May 2005 and December 2008. These lesions developed in 13 male and 3 female patients (mean age 41years; range 10-74years) due to various modes of trauma. The lesion involved the thigh region in 13 patients with trochanteric region, gluteal, lower back, and lower abdominal wall being other regions involved. An area of palpable fluctuance was the most consistent examination finding. Treatment was effected by fluid aspiration, doxycycline instillation, and compressive elastic bandaging. Healing was defined as the loss of fluctuation with complete absence of fluid on ultrasonography. RESULTS: The average duration of the persistence of the lesion was 13months (range, 6-23months). Most of the lesions had been aspirated previously multiple number of times, average being 3.44 times (range, 1-6 times). All lesions were aspirated and found to be negative on culture. The mean follow up period was 50.44months (range, 31-74months). 11 patients showed complete resolution of fluid collection at 4weeks with another 4 patients resolving at 8weeks follow up. The lesion persisted in one patient at 12weeks due to non-compliance to compressive elastic bandaging which subsequently resolved on repeating the procedure. All the lesions healed without any infections or necrosis. No recurrences were detected during the follow up period. A persistent non-fluctuant contour deformity, decreased skin mobility over the site of lesion, and feeling of tightness were the most common problems faced on long term follow up. CONCLUSION: Closed degloving injuries can be managed satisfactorily with doxycycline induced obliteration of the cavity with early healing time without recurrences.
Authors:
Abhishek Bansal; Naval Bhatia; Archana Singh; Ashwani Kumar Singh
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-26
Journal Detail:
Title:  Injury     Volume:  -     ISSN:  1879-0267     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Sports Injury Centre, Safdarjang Hospital, New Delhi 110029, India.
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