Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

Abstract

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

Degloving injuries with versus without underlying fracture in a sub-Saharan African tertiary hospital: a prospective observational study

“…There are often high energy involved, involving heavy vehicles with little protection as the case of motorcyclists [ 2 ]. This new trend is associated with underlying fractures in 40–85% [ 2 , 4 , 7 ]. They occur as monotrauma or as polytrauma with or without massive blood loss; this has a significance in the estimation of injury severity and the requirement of additional therapeutic options [ 8 , 9 ].…”

Patterns and management of degloving injuries: a single national level 1 trauma center experience

“…Degloving soft-tissue injuries (DSTIs) are often serious surgical conditions characterized by avulsions or detachment of the skin and subcutaneous tissue from the underlying muscle and fascia secondary to a sudden shearing force applied to the skin surface [ 1 ]. DSTIs are more commonly observed in males due to disproportionately higher burden of traumatic injuries [ 2 ]. Although it may occur anywhere in the body, the main sites of DSTIs are lower extremities, trunk, scalp and face with a variable amount of skin and soft tissue loss [ 3 – 5 ].…”

Degloving Injury: Different Ways of Management

“…Aggressive debridement aided by fluorescein vital dye staining followed by primary or delayed wound closure guided by local and systemic conditions is advocated by some 5 . Early plastic surgery evaluation and management of these patients have been associated with lesser number of surgeries and shorter hospital stay 6 . Clinical evaluation aided by use of fluorescein dye to assess the flap viability will guide whether skin can be harvested from the flap which can be stored for later use if general condition does not allow immediate grafting…”