Management of Degloving Injuries of the Lower Extremity

Zagrocki, Laura; Ross, Adrienne; Hicks, Adam

doi:10.1177/1938640012473147

Cited by 13 publications

(4 citation statements)

References 5 publications

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“…Zagrocki et al (29) demonstrated treatment of degloving injuries with a triple-layer small intestine submucosa wound matrix, VAC therapy, and subsequent split-thickness skin grafts. Their patient healed successfully with a full return to activities (29). Similarly, Wong et al (30) described VAC therapy for preparation of a degloved limb wound bed.…”

Section: Discussionmentioning

confidence: 96%

Empty Toe Phenomenon: A Rare Presentation of Closed Degloving Injury of the Foot

Bingham¹,

Fallat

2016

The Journal of Foot and Ankle Surgery

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Section: Discussionmentioning

confidence: 96%

Empty Toe Phenomenon: A Rare Presentation of Closed Degloving Injury of the Foot

Bingham¹,

Fallat

2016

The Journal of Foot and Ankle Surgery

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“…However, the treatment with Integra® relies on adequate vascular supply of the soft tissue bed, eradication of infection, off-loading and/or immobilization and the treatment with small-intestine submucosa required serial debridements. 18 , 19 Additionally, the use of dermal regeneration templates is expensive and not every hospital can afford treatment using this treatment. 18 We describe the use of degloved skin as a meshed full thickness skin graft.…”

Section: Discussionmentioning

confidence: 99%

Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh

Weinand

2018

wjps

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Degloving injuries of the upper extremity during work are rare nowadays, because of effective worker protection devices. However, these devastating injuries still occur today during motor vehicle car accidents and surgeons have to be aware of the possibilities of wound coverage for these large, contaminated wounds. We present two cases of degloving injuries of the hand and entire forearm using degloved skin as meshed full thickness skin graft to cover the entire wound. Two patients were admitted to our hospital, presenting large degloving injuries of the entire forearm and hands. Both patients sustained their injuries by being dragged by moving trains and presented additional fractures of the metacarpal bones and in both cases the little finger had to be amputated. The degloved skin was cleansed and meshed as a full thickness skin graft 1:3, using a Brennen Mesher. In both patients, complete wound coverage was achieved using the degloved skin as meshed full thickness skin graft. Attachment to the wound was achieved by vacuum closure device, however, ninety percent of the graft did attach. In both cases, shrinking of the full thickness skin grafts was noted. Both of them received physiotherapy and gained nearly complete function of the injured hand and wrist. When larger parts of skin are lost in degloving injuries meshing the degloved skin as full thickness skin grafts good wound coverage of larger, contaminated defects can be achieved.

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“…Although extensive evidence exists for the use of NPWT to manage lower extremity open traumatic wounds, evidence specific to the foot or ankle is limited to case reports (Level IV evidence). 4,6,52,56 Therefore, current evidence to support the use of NPWT for acute traumatic open wounds of the foot and ankle is insufficient (grade I recommendation).…”

Section: Evidence For Npwt In Foot and Ankle Surgerymentioning

confidence: 99%

“…10,12,42 This section will review the results for various types of wounds managed with NPWT and provide a graded recommendation for each application (Tables 3 and 4). 4,6,52,56 Therefore, current evidence to support the use of NPWT for acute traumatic open wounds of the foot and ankle is insufficient (grade I recommendation).…”

Section: Evidence For Npwt In Foot and Ankle Surgerymentioning

confidence: 99%

Negative-Pressure Wound Therapy in Foot and Ankle Surgery

et al. 2019

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Negative Pressure Wound Therapy (NPWT) is frequently utilized to manage complex wounds, however its mechanisms of healing remain poorly understood. Changes in growth factor expression, micro- and macro-deformation, blood flow, exudate removal, and bacterial concentration within the wound bed are thought to play a role. NPWT is gaining widespread usage in foot and ankle surgery, including the management of traumatic wounds; diabetic and neuropathic ulcers; wounds left open after debridement for infection or dehiscence; high-risk, closed incisions; tissue grafts and free flaps. This article reviews the rationale for NPWT, its proposed mechanisms of action, and the evidence regarding its clinical applications within the field of foot and ankle surgery. Level of Evidence: Level V, expert opinion.

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Management of Degloving Injuries of the Lower Extremity

Abstract: Therapeutic Level IV, Case Study.

Cited by 13 publications

References 5 publications

Empty Toe Phenomenon: A Rare Presentation of Closed Degloving Injury of the Foot

Empty Toe Phenomenon: A Rare Presentation of Closed Degloving Injury of the Foot

Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh

Negative-Pressure Wound Therapy in Foot and Ankle Surgery

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