Deep dissecting hematoma: A plaidoyer for an early and specialized management

Trellu, Laurence Toutous; Weiss, Lucien; Tarteaut, M.-H.; Kaya, Aysin; Cheretakis, Alexandre; Kaya, Gürkan

doi:10.1016/j.eurger.2010.07.001

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…The treatment of DDH comprises an invasive procedure (deep incision or surgical debridement) followed by conservative treatments. 3 , 4 , 9 Negative wound pressure therapy (NWPT) is recommended by some authors when skin grafting is being considered, 9 and the majority of articles on DDH mention the use of NWPT, 3 , 10 – 12 despite the low level of evidence supporting its value. 13 , 14 Post-operative wound management was limited to local care and dressings in only two reported DDH cases.…”

Section: Discussionmentioning

confidence: 99%

“…Management of severe dermatoporosis involves prevention, particularly against trauma in the population identified as being at risk of DDH, and entails the risk of falls (by adapting furniture in the home, layout of the carpets), visual disorders’ correction, and lower limbs’ protection. 4 , 9 , 10 , 11 , 16 The signs of dermatoporosis and its complications, such as DDH, must also be early recognized by caregivers, carer, and patients affected by dermatoporosis, because the earlier the hematoma is removed, the less likely it is that the patient will sustain severe skin damage. 4 , 9 …”

Section: Discussionmentioning

confidence: 99%

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Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Hamdan¹,

Zwetyenga²,

Macheboeuf³

et al. 2022

SAGE Open Medical Case Reports

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A deep dissecting hematoma is the most serious complication of dermatoporosis, consisting of a rapidly expanding blood collection that splits the hypodermis from the muscle fascia. A several-week time lapse between a minor trauma-induced superficial hematoma and its sudden evolution into a rapidly spreading deep dissecting hematoma is unusual. We report the case of a 70-year-old woman with long-term oral anticoagulation and dermatoporosis who suddenly developed a rapidly spreading right-leg deep dissecting hematoma 1 month after minor trauma, for which a surgical debridement and drainage were performed. Only local care and absorbent dressings were used to manage the post-operative wound, and within 4 months, the wound had healed. In this report, we emphasize the importance of preventing deep dissecting hematoma in patients who are at risk as well as the need to weigh the benefits and risks of anticoagulants when dermatoporosis cutaneous signs are present. A limb-threatening deep dissecting hematoma may develop suddenly, even weeks after a minor impact. In order to prevent skin necrosis from occurring, caregivers, patients, and carers must be able to identify this condition early on.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report

Hamdan¹,

Zwetyenga²,

Macheboeuf³

et al. 2022

SAGE Open Medical Case Reports

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“…Histologically, there is exposure of deep skin vessels to the skin surface in the context of significant skin thinning. Unlike the other clinical signs of DP, DHH occurs mostly in the lower limbs of elderly adults with severe DP (M/F ratio: 1/5) ( 38 ). Necrosis is caused by large hematomas that cut off the blood flow to the skin.…”

Section: Dermatoporosismentioning

confidence: 99%

Osteoporosis and dermatoporosis: a review on the role of vitamin D

Romano,

Serpico,

Cantelli

et al. 2023

Front. Endocrinol.

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Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body’s capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.

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“…This is the most severe complication of dermatoporosis. DDH is thought to result from a trauma‐induced massive bleeding between subcutaneous fat and muscle fascia, from fragile and aged vessels localized very close to skin, as a result of extreme skin atrophy …”

Section: Complications Of Dermatoporosismentioning

confidence: 99%