Unusual Presentation of a Morel-Lavallée Lesion at a Skin Graft Donor Site in the Absence of Trauma

Abstract

A Morel-Lavallée lesion (MLL) is a closed internal degloving injury where the skin and subcutaneous tissue separate from the underlying fascia, creating a fluid-filled space. Typically linked to high-energy trauma, such as pelvic or thigh injuries, it can also occur in unusual contexts and have delayed presentations. This case describes a 60-year-old lady who developed a painless swelling at her right thigh split-thickness skin graft donor site six months after surgery for a humerus fracture and forearm degloving injury. Imaging confirmed an MLL, but conservative drainage failed. Surgical excision and histopathology confirmed the diagnosis. This case emphasises the diagnostic challenge of MLLs without overt trauma, especially in post-operative settings. Management options include imaging for diagnosis, percutaneous drainage, quilting sutures, and surgical excision for chronic lesions. Early recognition is critical to prevent complications and morbidity, underscoring that MLL should be considered in recurrent post-operative soft tissue swellings even without a history of trauma.