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Acute Traumatic Arterial Occlusions Combined with Massive Morel-Lavallee Lesions Treated by Percutaneous Angioplasty, Multiple Debridements and Skin Grafts

Vascular Specialist International 2020년 36권 3호 p.174 ~ 179
조성우, 윤상철, 원성훈, 천동일, 김철한, 박병원,
소속 상세정보
조성우 ( Cho Sung-Woo ) - Soonchunhyang University Seoul Hospital Department of Surgery
윤상철 ( Yun Sang-Chul ) - Soonchunhyang University Seoul Hospital Department of Surgery
원성훈 ( Won Sung-Hun ) - Soonchunhyang University Seoul Hospital Department of Orthopedic Surgery
천동일 ( Chun Dong-Il ) - Soonchunhyang University Seoul Hospital Department of Orthopedic Surgery
김철한 ( Kim Chul-Han ) - Soonchunhyang University Seoul Hospital Department of Plastic Surgery
박병원 ( Park Byoung-Won ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine

Abstract


Morel-Lavallee lesions (MLL) create pre-fascial space by shearing the subcutaneous tissues away from the underlying fascia, in a patient with trauma. Necrosis of the overlying skin can develop over a wide area of the lesion. The lesion might be contaminated by the surgical site due to careless intrusion when treating the combined arteriopathy. A 70-year-old woman presented with avulsion of the skin over the right foot and bilateral leg pain following a car accident. Computed tomography showed bilateral popliteal artery occlusion with large hematoma on both legs. Percutaneous angioplasty was performed with successful restoration of the flow. However, the skin color changes over time. Necrosis of the skin occurred over a wide area of the right leg. Extensive debridement was performed, and the defect was covered with a skin graft. MLLs can occur in patients with multiple traumas, multiple vascular injuries, and complex skeletal injury. Vascular surgeons treating multiple traumas should be aware of the diagnostic and management options for MLL. It should be diagnosed early because it can be difficult to manage once the overlying skin develops necrosis.

키워드

Morel-Lavallee; Popliteal artery; Angioplasty; Stents; Thrombosis; Occlusion

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