Is more better? Evaluating the impact of early surgical debridement on Morel-Lavallee lesions

Introduction: Morel-Lavallee lesions (MLL) are closed degloving injuries, often requiring complex management when infected. We evaluated if early debridement reduces infection risk compared to observation. Methods: We conducted a single-center retrospective study of MLL in adults from 2012 to 2022, analyzing diagnoses, infection, demographics, and hospital outcomes. Patients undergoing debridement within 48 h were compared to those initially observed. Results: Of 219 patients, 79 (36 %) underwent initial surgical debridement, and 140 (64 %) were initially observed. The overall infection rate was 9%. The surgery group had longer hospital stays (14vs7 days, p < 0.001) and more debridements (2vs0, p < 0.001). While infection rate was higher in the surgery group (13.9%vs6.4 %, p 1/4 0.064), this difference was not statistically significant. Multivariate analysis identified higher BMI, hip location, and RBC transfusions as significant infection predictors. Conclusion: No significant differences in infection rates were found, but several risk factors were identified. Greater awareness and better study designs are needed for improved MLL management guidelines.