Degloving of a body part is a serious injury, which happens when the skin’s top layers are torn from the muscles, connective tissues, and bones. Although it can involve any part of the body, it usually happens in the lower extremities.
According to a study published in the World Journal of Emergency Surgery, a third of degloving injury cases are traffic-related injuries. Another study in the Journal of Orthopaedic Surgery and Research cites that 45 percent of degloving injuries affect the lower limbs (legs).
A degloving injury is classified into two types: Open and Closed.
As its name suggests, this type of degloving injury means that the muscles, bones, and tissues are exposed. Even if the skin is still partially attached near the wound, this is still considered as an open type.
This case is most common among traffic accident victims, sports injuries, equipment or machine injuries, or severe animal bites. Open degloving is a very serious condition due to the risk of blood loss and infection.
It’s not always easy to spot a closed degloving injury following an accident. In many cases, the degloving might even look like a bruise, thus resulting in a delayed diagnosis, according to the Journal of Clinical & Diagnostic Research.
What happens during a closed degloving injury is that the top layer of the skin separates from its deeper tissues. The space between these two areas may develop into lesions filled with blood, fat, and lymph fluid.
A hip bone injury is more prone to become a closed degloving injury. However, it may also occur on the buttocks, torso, shoulder blades, and knees.
Degloving treatment in Miami will depend on the type. Between the two, open degloving is always considered as an emergency case. A patient with exposed muscles, bones, and tissues will need to be brought to a hospital facility with a trauma center because procedures–like reattaching the skin or body part (such as the toes or fingers) or the amputation of the injured body–are time-sensitive. The doctors might also have to perform a skin graft.
As soon as the patient is declared stable and the bleeding has been controlled, then attention will be directed to the body part or limb that has been degloved to determine what may be salvaged, replanted, or grafted. At this point, the trauma doctors may need to consult with plastic surgeons regarding the best course of action. If there are fractures, orthopedic surgeons will also have to be brought in during the decision-making process. Sometimes, infectious disease experts might also be called to help the trauma team.
It goes without saying that an open degloving injury will require multiple surgeries, including reconstructive surgery, especially for severe injuries. After a few weeks or months, the patient may also have to undergo plastic surgery to improve the scar’s appearance for aesthetics and function. Thus, a longer hospital stay cannot be avoided when full recovery is the goal.
Closed degloving injury treatment, on the other hand, may also require hospital stay and surgery because there could be a need to drain the fluid or remove the dead tissue within the lesions. Though these procedures are not as extensive or intrusive as the surgeries for open degloving cases, the patient will still need to go to the hospital as draining and dead tissue removal require anesthesia and the use of proper medical tools at the hands of an expert surgeon.
Some closed degloving injury patients may also have to undergo sclerotherapy. Thus, frequent returns to the hospital might also be necessary.
Whether you have an open or closed degloving injury, you need to have adequate rest and undergo physical therapy at least three times a week as a post-operative procedure.
Regardless of the degloving injury type, follow up treatments and succeeding reconstructive and plastic surgeries must be pursued to prevent the risk of poor outcomes and complications that might affect the patient’s quality of life and mental health.
These risks and complications include:
Plastic surgery may be done soon after the trauma surgery. If the wounds from the degloving injury left an ugly scar, then further plastic surgery for scars can be undertaken upon consultation with Dr. Zaydon – our expert plastic surgeon in Miami.
The key to surviving and managing life after a degloving injury is a team of medical experts and patient compliance. A series of surgeries, including cosmetic surgery, as well as a series of physical therapy and psychological therapy, will not only improve the patient’s quality of life but also give the patients a renewed outlook despite the ordeal they went through.
If you would like further information about available treatment options for a degloving injury, you may visit our FAQs page or schedule a consultation with Dr. Zaydon.
Dr. Zaydon is certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons. He is also a fellow of the American College of Surgeons. Dr. Zaydon serves as an expert witness on liability cases around the country. He has reviewed many cases and has served as an expert witness for both plaintiff and defendant.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.