INTRODUCTION AND IMPORTANCE: A Morel-Lavallee lesion is a closed degloving 
injury due to traumatic separation of the hypodermis from underlying fascia. 
Accumulation of hemolymphatic fluid that occurs is a potential habitat for 
bacteria. Management options include percutaneous aspiration, open debridement, 
or a non-surgical approach, each with recurrence risk. In the event of 
recurrence, sclerotherapy is used. In this case report, after reviewing povidone 
iodine's efficacy in treating seromas, we used it as a sclerosant for recurrent 
Morel-Lavallee lesion as the more established options were unavailable in our 
setting.
CASE PRESENTATION: A 49-year-old with no known comorbid presented following a 
motor traffic accident, with left lateral thigh swelling. He was stable 
systematically, with a tense, tender left lateral thigh swelling and intact 
neurovascular assessment distally. X-ray and computed tomography ruled out 
skeletal and vascular injuries. Magnetic resonance imaging revealed a 580 ml 
type 1 Morell-Lavallee lesion. Open surgical debridement was done to drain and 
debride the lesion. He developed two recurrences that necessitated percutaneous 
aspiration. Doxycycline and talc sclerosants were considered; however, due to 
their unavailability, povidone iodine was used. It is now five months 
post-intervention without increased pain, recurrence, or wound complications.
CLINICAL DISCUSSION: Recurrence is hypothesized to be due to the persistence of 
fluid loculations, unobliterated dead space, and pseudocyst formation. 
Sclerotherapy stimulates inflammation that results in fibrosis of the cavity 
walls causing its obliteration. Doxycycline, the most studied sclerosant in 
Morel-Lavallée lesion has an efficacy of 95.7%.
CONCLUSION: The current report is the first successful use of povidone iodine 
for sclerotherapy of recurring Morel-Lavallée lesions. Based on povidone iodine 
experiences as a sclerosant, it is associated with increased analgesic 
requirements. We cautiously propose its use as an alternative in settings where 
talc powder and doxycycline powder are unavailable.