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RACS ASC 2024

Free flap reconstruction of a Morel Lavallee lesion: a novel technique for recalcitrant lesions

Poster

Presentation Description

Institution: Royal North Shore Hospital - NSW, Australia

The treatment of Morel Lavallée lesions (MLL) presents a complex challenge, often resistant to conventional measures, such as compression, drainage, sclerotherapy and debridement, leading to recurrent and complicated seroma formation with up to 75%. Here, we report a novel approach in managing a 45 year old man with a recalcitrant MLL. Despite a complex medical background, including a history of kidney transplant, ischemic heart disease, and asthma, the patient recovered successfully after a radical debridement and free flap reconstruction as a single stage procedure. The patient presented with a left lateral thigh hematoma and pretibial laceration following a motorbike crush injury. Despite initial treatment with drainage and local flap repair, recurrent seroma on the left thigh ensued, requiring six operative debridements. Subsequent radical debridement and capsulectomy followed by anterolateral thigh (ALT) free flap reconstruction, marked a pioneering approach to address this challenging condition. Microanastomosis of the ALT free flap harvested from the contralateral thigh vasculature facilitated tissue reconstitution on the left thigh and subsequent recovery. The utilisation of free flap reconstruction offered multifaceted benefits, including dead space obliteration, contour reconstruction and the redistribution of lymphatics through fasciocutaneous tissues, addressing the underlying pathology of MLL. This pioneering case report underscores the significance of innovative surgical techniques in managing complex MLL cases refractory to conventional treatments. Our approach contributes to the understanding of MLL management, emphasising the need for tailored intervention to achieve positive outcome and recovery.

Speakers

Authors

Authors

Dr Michael Cheung - , Dr Bish Soliman - , Dr Varun Harish -