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The following is a summary of “Is More Better? Evaluating the Impact of Early Surgical Debridement on Morel-Lavallee Lesions,” published in the February 2025 issue of American Journal of Surgery by Barrera et al.

Morel-Lavallée lesions (MLL) are closed degloving injuries characterized by the separation of the skin and subcutaneous tissues from underlying fascia, often resulting in fluid accumulation and potential infection. Managing MLL, particularly in the presence of infection, remains complex, and the role of early surgical intervention in mitigating infection risk is not well established. This study aimed to evaluate whether early surgical debridement within 48 hours of diagnosis reduces the risk of infection compared to an initial observational approach. 

Researchers conducted a retrospective, single-center analysis of adult patients diagnosed with MLL between 2012 and 2022. Data on demographics, clinical presentation, infection rates, hospital course, and outcomes were extracted and analyzed. 

Patients were stratified into two groups: those who underwent surgical debridement within 48 hours of diagnosis and those who were initially managed with observation. Among the 219 patients included, 79 (36%) underwent early surgical debridement, while 140 (64%) were initially observed. The overall infection rate across the cohort was 9%. Patients in the early debridement group had a longer median hospital stay (14 vs. 7 days, P<0.001) and required more surgical debridements (2 vs. 0, P<0.001). Although the infection rate was higher in the surgical group compared to the observation group (13.9% vs. 6.4%), this difference did not reach statistical significance (P=0.064). Multivariate analysis identified higher BMI, lesion location at the hip, and the need for red blood cell transfusions as independent predictors of infection. 

These findings suggest that while early debridement does not significantly reduce infection risk in MLL, certain patient-specific factors contribute to infection susceptibility. Further prospective studies with larger cohorts and standardized treatment protocols are necessary to refine management guidelines and optimize outcomes in patients with MLL.

Source: americanjournalofsurgery.com/article/S0002-9610(25)00060-1/abstract