Postoperative seroma is a common complication of many surgical procedures in 
which anatomical dead space has been created. A particular case of lesion in 
which seroma occurs is the Morel-Lavallée lesion (MLL), which is an uncommon 
closed soft-tissue degloving injury that develops after high-energy trauma or 
crush injury where shearing forces separate the subcutaneous tissue from the 
underlying fascia. The diagnostic evaluation begins with an adequate history and 
physical examination, followed by instrumental research with ultrasonography, 
computed tomography, and magnetic resonance imaging. Postoperative seromas and 
MLLs share a similar pathology and natural evolution as both injuries, once 
chronic, develop a pseudobursa; thus, the authors think that the same treatment 
algorithm may be suitable for both the lesions. Several strategies for the 
treatment of post-surgical and post-traumatic seromas have been described in the 
literature, ranging from conservative measures for acute and small injuries to 
surgical management and sclerotherapy for chronic and large ones. Despite some 
seromas resolving with conventional management, lesion recurrence is a matter of 
concern. The authors present their experience in the treatment of both 
post-surgical and post-traumatic chronic seromas not responsive to conservative 
treatments by surgical drainage of the seroma, capsulectomy, and application of 
vacuum-assisted closure therapy to allow granulation tissue formation, dead 
spaces obliteration, and wound healing. Primary wound closure with closed 
suction drain placement and an elastic compression bandaging are finally 
performed. From 2014 to 2019, a total of 15 patients (9 females and 6 males) 
were treated for recurrent chronic seromas with the proposed surgical approach. 
Five cases were MLLs, while 10 cases were postoperative seromas. The patients 
were between 33 and 79 years old, and they were followed up at 4 weeks and 3 and 
6 months after surgery. All 15 patients with chronic seromas not responsive to 
conservative treatment showed a complete resolution of the lesions with the 
proposed treatment approach with no evidence of lesion recurrence, proving its 
effectiveness.