Treatment of Morel-Lavallée Lesions (MLLs) with Mesh Incisions Combined with Quilting Sutures and Negative Pressure Wound Therapy (NPWT).

Purpose: The objective of this retrospective study was to evaluate the clinical effects of a novel treatment approach for Morel-Lavallée lesions (MLL) using a combination of suturing techniques and Negative Pressure Wound Therapy (NPWT) with mesh incisions. To summarize the clinical effects of a combination of suturing techniques and (Negative Pressure Wound Therapy) NPWT on the wall of Morel-Lavallée lesions (MLL) fibrotic pseudocapsules with mesh incisions in the treatment of MLLs. A retrospective analysis was performed on MLL patients from April 2017 to March 2021.

Methods: This a retrospective case-control study and thirteen MLL patients were included in this retrospective analysis conducted between April 2017 and March 2021, who were treated with mesh incisions on the wall of the pseudocapsule, quilting suturing to degloved soft tissues, and NPWT. Physical examination, MRI, or ultrasound before surgery confirmed the diagnosis. Wound healing, secondary infection, recurrence, visual analog scale (VAS) scores before and after surgery, and skin and soft tissue condition were observed and evaluated.

Results: The combination of mesh incisions, quilting sutures, and NPWT led to successful wound healing in 11 out of 13 cases without recurrent hematoma or secondary infection. Visual analog scale (VAS) scores significantly decreased after the operation, and the aesthetic and tactile qualities of the injured area improved. One case of skin and soft tissue necrosis infection before the operation, which healed after second-stage full-thickness skin grafting, 1 case healed after a dressing change, and the remaining 11 cases had wounds that healed by the first stage without secondary infection or recurrent hematoma formation. VAS scores decreased significantly after the operation, the appearance of the injured area was as expected, and the skin feel and elasticity recovered satisfactorily.

Conclusion: The study demonstrates that the mesh incision technique, along with mattress sutures and NPWT, presents a feasible and effective approach for treating MLL with fibrotic pseudocapsules. This could shorten healing times, reduce risk of complications, and improve patient satisfaction.