In my previous post, I reviewed some of the basics of Morrel-Lavallee lesions. In this one, I’ll discuss a very recently published paper that explores early versus late management.

Although these lesions are relatively common after unprotected blunt trauma (e.g., motorcycle crashes), there has not been a lot of definitive literature published. The Morrel-Lavallee study group published this study, which was coordinated at the University of California, Irvine. It was a multicenter, prospective, observational study involving 15 trauma centers.

The study included any adult patient undergoing surgical management of the lesion, with no exclusions during the study. Surgical management included percutaneous or open drainage, wound excision and debridement, vacuum-assisted closure, or any other operative procedures. The primary outcome was hospital length of stay, and secondary outcomes included wound-related and other complications (cellulitis, deep wound infection, skin necrosis, organized hematoma, etc.), stratified by time to injury treatment. Early treatment was defined as occurring within 48 hours of admission, and late management as occurring after 48 hours.

Here are the factoids:

• There were 230 patients with this diagnosis seen over a 3-year period; 150 underwent surgical intervention and were included in the study.
• Demographics, BMI, ISS, and comorbidities were similar in both groups.
• Two-thirds underwent early operative intervention, and one-third late.
• The number of surgical procedures (5 vs. 4) and wound complications (20% vs. 24%) were similar across both groups (early vs. late).
• ICU length of stay in the early treatment group was significantly shorter (2 vs. 5 days); hospital length of stay was also shorter (12 vs. 20 days) but did not quite achieve significance (p=0.06). 

Bottom line: This relatively large study showed little difference in wound complications, but shorter ICU and hospital lengths of stay if Morrel-Lavallee lesions are treated within 48 hours of arrival. Although this length-of-stay difference could reflect disparities in lesion location or other injuries sustained, the authors attempted to control for this. They showed that injury severity scores were similar across groups. Trauma professionals should begin treatment as soon as practical after admission to reap the benefits of a shorter hospital stay and potentially lower costs to the patient. 

Reference: Early vs Late Surgical Intervention for Morel-Lavallée Injuries: A Pacific Coast Surgical Association Prospective Multicenter Study. J Am Coll Surg. 2026 Sep 1;243(3):651-659. doi: 10.1097/XCS.0000000000001918. Epub 2026 Aug 14. PMID: 42599047.