Degloving is a very rare condition, affecting the eyelids, nose, ears, and jaw. It is painful and can damage the face permanently. If untreated, it may require plastic surgery or complex skin repair. It can also have a significant impact on the victim’s mental health. As a result, victims of degloving injuries deserve compensation for the losses they incur.
Surgical management of degloving injuries
Surgical management of degloving soft-tissue injuries requires careful assessment of the extent of devitalized tissue and the blood supply to the affected area. Principles of treatment include preservation of as much of each structure as possible, early primary definitive skin cover, and return of function. If the degloving injury is severe, it may be necessary to undergo secondary procedures. In some cases, replantation may be feasible. However, this requires extensive expertise and resources.
Early management complications have been associated with the pattern of degloving injuries. In a Chinese study, the incidence of early management complications was highest for pattern three injuries; however, treatment outcome was better for patients with pattern one or two degloving injuries. In addition, age did not seem to affect the incidence of early complications.
A rotational injury to a lower extremity may result in an avulsion of the skin and subcutaneous fat. This free-floating segment of skin can become ischemic or slough off completely. Surgical management of degloving injuries should include repeated drainages and proper debridement. While this type of injury does not require immediate surgery, it is important to treat it as soon as possible.
Degloving injuries of the lower extremity are common, and can be life-threatening. Although most degloving injuries are minor, they carry high rates of morbidity and mortality. In addition, they can result in significant blood loss and destabilization of the patient. Surgical management of degloving injuries in children is particularly complex, and advanced surgical techniques may be necessary in the most severe cases.
Open degloving soft tissue injuries are managed with conservative management techniques, whereas closed degloving injuries require surgical drainage. Open degloving injuries require approximately 19 hours to deglove, and skin grafting may take five days to heal. Surgical management of degloving injuries requires careful monitoring, but the outcome depends on the anatomic location, force of injury, and presence of any other associated injuries.
The primary goal of surgical management of degloving injuries is early coverage of the deficit to prevent devastating complications. However, definitive closure of the wound is difficult due to debris and edematous swelling. Moreover, surgical management of degloving injuries should be multistaged to provide optimal functional outcomes. Return to normal activity should be the goal of treatment, especially for pediatric patients.
Diagnosis of degloving injury
A degloving injury is a serious medical condition that often requires prompt treatment. Early diagnosis is key to preventing infection and minimizing any damage to your skin. Treatment options for degloving injuries depend on the extent and location of the wound. In many cases, degloving injuries require a lengthy hospital stay and several surgeries. In more severe cases, amputation may be necessary.
A degloving injury occurs when the top layer of skin is separated from deeper tissues. Typically, this happens at the hip bone, but can also involve the torso, buttocks, lower back, and shoulder blades. While degloving injuries are difficult to diagnose, physicians often use a clinical picture to make a diagnosis. The doctor will ask about the accident and perform a physical exam.
Degloving injuries occur as a result of trauma. The top layers of skin are ripped from the underlying tissue, compromising blood vessels, nerves, and fascia. Symptoms of degloving injuries range from minor discomfort to a life-threatening condition. This injury usually involves massive blood loss and tissue death.
A degloving injury can be a result of a fracture, an abscess, or vascular damage. It can also result in compartment syndrome of the thigh. Diagnosis of degloving injuries is often made by a combination of physical examination, laboratory tests, and imaging studies. X-rays and MRI scans are used to evaluate the extent of the injury and any associated issues.
Diagnosis of degloving injury can be difficult, because the symptoms can be delayed or absent. Since the injury is life-threatening, initial attention is focused on evaluating the underlying cause. However, the symptoms of degloving injury tend to become more obvious with time. The skin may swell or become fluid-filled, and a clinician should carefully examine the affected skin.
A degloving injury may cause significant blood loss, and patients may experience blood pressure or heart rate increases. Physicians will likely prescribe IV fluids to prevent further blood loss. They may also administer blood transfusions to help the patient recover faster. In some cases, degloving injuries may result in permanent damage to the skin and may require extensive rehabilitation.
Treatment options
Degloving injuries are traumatic and can lead to life-threatening complications. Early treatment is critical for preventing infection. Treatment typically involves an extended hospital stay, a number of surgeries, and months of physical therapy. Depending on the severity, degloving injuries may require multiple surgeries. For these patients, physical therapy is essential for the recovery process.
Degloving injuries can be classified based on the depth and number of layers removed. A shallow degloving injury may involve only a bruise, while a severe one can remove multiple layers of skin and subcutaneous tissue. Regardless of the type of degloving injury, treatment options vary. Typically, a physician will perform a physical exam and ask about the nature of the injury to get an accurate diagnosis.
In cases where the degloving injury is severe, patients may require plastic surgery. Plastic surgeons can reattach a degloved piece of skin to a limb or re-graft skin from another part of the body. In some cases, a partial degloving injury may require amputation. However, in minor injuries, compression bandages and rest may be sufficient. For more severe degloving injuries, the doctor may perform a skin graft and drain fluid or tissue to facilitate healing.
Surgical treatments for degloving can be complex and challenging. In general, early treatment is critical for restoring function and preventing infection. Nonsurgical procedures can include the replantation of the hand with a graft from a superficial forearm vein. In a recent case, a 35-year-old man underwent surgery for degloving of the right hand. In this case, the superficial forearm vein was transplanted intraoperatively to re-establish blood circulation. The patient was followed for two years and had a satisfactory recovery.
Degloving may occur on multiple fingers at the same time. Most frequently, degloving involves the distal portion of the hand. The thumb is especially susceptible to degloving, as it is slightly out of the palm and more vulnerable to shearing forces. Rarely, the degloved finger is completely amputated. Depending on the severity of the degloving, the nail bed may be retained on the stump.
Cost of degloving injury
A degloving injury can be a serious wound that needs immediate medical attention. Treatment options vary, depending on the severity of the wound. The injury usually leaves a scar. It may require long-term therapy, rehabilitation, or regular follow-up care from a doctor. It may even leave you without the functionality of the affected body part.
In the study, 51 patients were diagnosed with degloving injuries. Of these, 1% of the patients were found to have an underlying fracture. Female patients were more likely to sustain a degloving injury than male patients. The average age was 28 years old. The majority of degloving injuries resulted from a road traffic collision. About a third occurred due to a shock that resulted in admission.
The most common areas to suffer from degloving injuries are the arms and hands. But this type of injury can also affect the legs, abdomen, chest, and shoulders. Closed deglovings are not as visible, but they still need medical attention. Deglovings occur when a large force is applied to the skin. Even with protective clothing, degloving injuries can still occur.
Treatment for degloving injuries involves assessing the level of devitalized tissue, the layers of tissue that form the flap, and whether or not the degloving injury is due to an underlying fracture. The underlying fracture should be assessed and treated early to increase flap viability and reduce the risk of infection. The sooner the surgery is performed, the better the chance of a successful outcome. Even if the flap does not have an underlying fracture, it can still be useful as a donor skin graft.
Degloving injuries are considered traumatic injuries. They involve extensive portions of skin detached from bone surfaces and muscle tissue underneath. The injury is commonly associated with a fracture, so it is important to seek prompt medical attention to avoid complications. In the short term, degloving injuries can result in high medical expenses, as they typically result in extensive tissue loss and significant morbidity.
