Gautam Kumar1, Alagu Pandiyan1, Bipin Theruvil1.
Abstract
OBJECTIVE: This study looks at the outcome of percutaneous quilting technique for the treatment of closed degloving injuries or Morel-Lavallée lesions (MLL).
DESIGN: Prospective single-centre nonrandomized case series. PARTICIPANTS: Patients with MLL visiting our hospital between January 2012 and May 2018.
METHOD: The method involves percutaneous single-stage suturing of skin and deep fascia with heavy, non-absorbable, non-braided sutures starting from periphery to centre. OUTCOME MEASURES: Resolution of the lesion.
RESULTS: Twenty-two patients with MLL treated, which included 18 males and 4 females with an average age of 22 (range 16-52). Lesions varied in length from 12 to 60 cm. The average time gap from the injury to drainage of the lesion was 7 days (range 2-60 days). We followed these cases weekly for 4 weeks and then once a month until 6 months and then at the end of the year. All 22 cases healed uneventfully.
CONCLUSION: Percutaneous drainage along with suturing of the skin and subcutaneous tissue to deep fascia prevents the discordant movement and obliterates the dead space-aiding apposition of the layers. This is a simple and effective procedure with low recurrence rates that addresses the primary pathology of MLL. LEVEL OF EVIDENCE: Therapeutic level IV. © Indian Orthopaedics Association 2020.
OBJECTIVE: This study looks at the outcome of percutaneous quilting technique for the treatment of closed degloving injuries or Morel-Lavallée lesions (MLL).
DESIGN: Prospective single-centre nonrandomized case series. PARTICIPANTS: Patients with MLL visiting our hospital between January 2012 and May 2018.
METHOD: The method involves percutaneous single-stage suturing of skin and deep fascia with heavy, non-absorbable, non-braided sutures starting from periphery to centre. OUTCOME MEASURES: Resolution of the lesion.
RESULTS: Twenty-two patients with MLL treated, which included 18 males and 4 females with an average age of 22 (range 16-52). Lesions varied in length from 12 to 60 cm. The average time gap from the injury to drainage of the lesion was 7 days (range 2-60 days). We followed these cases weekly for 4 weeks and then once a month until 6 months and then at the end of the year. All 22 cases healed uneventfully.
CONCLUSION: Percutaneous drainage along with suturing of the skin and subcutaneous tissue to deep fascia prevents the discordant movement and obliterates the dead space-aiding apposition of the layers. This is a simple and effective procedure with low recurrence rates that addresses the primary pathology of MLL. LEVEL OF EVIDENCE: Therapeutic level IV. © Indian Orthopaedics Association 2020.
Entities:
Keywords:
Degloving injury; Discordant movement; Fluctuant swelling; Hypermobile skin; Morel-Lavallée lesion; Percutaneous draining; Post-traumatic degloving; Quilting sutures; Quilting technique; Shear injury
Year: 2020
PMID： 32850020 PMCID： PMC7429629 DOI： 10.1007/s43465-020-00097-4
Source DB: PubMed Journal: Indian J Orthop ISSN： 0019-5413 Impact factor: 1.251