• Journal of Trauma and Injury
• /
• v.36 no.4
• /
• pp.385-392
• /
• 2023

Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.

• Journal of Veterinary Clinics
• /
• v.37 no.1
• /
• pp.53-56
• /
• 2020

A wild juvenile bean goose (Anser fabalis serrirostris) was rescued after sustaining an extensive degloving injury around the neck and chin region. Except for the degloving injury, physical and radiographic examination detected no other trauma-induced abnormality. On the day of presentation to the hospital, the patient underwent extensive debridement and suturing. A twice-daily force feeding with diluted parrot weaning food was required during the hospitalization due to severe anorexia. On day 18, the bean goose was moved to the aviary to undergo rehabilitation and feeding by itself. Management of the severe degloving injury of the cervical region with medical intervention and nutritional assistance was successful in this case, and the results of this case shows the proper management can be implemented to produce satisfactory outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.3
• /
• pp.174-177
• /
• 2022

Facial degloving injuries are due to separation between the skin and subcutaneous tissues from the underlying muscles, bones, and fascia. These injuries often create a reconstructive challenge for surgeons especially when there are associated complications like wound infection or necrosis of the avulsed flap. This case report presents management of a case of facial degloving injury with full thickness necrosis of the avulsed flap. The authors concluded that treatment of such complex wounds requires a multi-disciplinary approach along with proper planning and staging of the surgical procedures for optimum aesthetic and functional outcomes.

• Archives of Reconstructive Microsurgery
• /
• v.19 no.2
• /
• pp.88-92
• /
• 2010

The forefoot reconstruction is a challenging field for plastic surgeons. Weight bearing tolerability and stability are important factor of choosing reconstruction methods, but cosmetic aspect has to be considered. 51 year old man visited our clinic with extensive degloving injury on right forefoot by roller. The soft tissue defect started from metatarsal area to the toe tip including nails. We harvested the anterolateral thigh flap and transferred it to the forefoot defect area with nerve coaptation. The flap was successful without skin necrosis or other complications. Secondary flap debulking surgery was performed after ten months from initial operation. Patient was satisfied with functional and cosmetic outcomes. The patient was able to wear shoes and walk with adequate sensory recovery. As there is few report about reconstruction of forefoot soft tissue defects, we report a unique case of the anterolateral thigh innervated free flap reconstruction in degloving injury.

• Journal of Trauma and Injury
• /
• v.21 no.2
• /
• pp.140-143
• /
• 2008

Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of $2{\times}3.5cm^2$ on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.

• Proceedings of the Korean Society of Veterinary Clinics Conference
• /
• 2009.10a
• /
• pp.221-221
• /
• 2009

• Archives of Reconstructive Microsurgery
• /
• v.16 no.2
• /
• pp.113-118
• /
• 2007

Purpose: The purpose of this work was to describe the results of treatment for motor vehiclerelated crushing injuries among children and adolescents under sixteen years in Korea. Materials and Methods: A retrospective analysis was conducted of data from children who were under sixteen year and injured foot by motor vehicles. Cases were documented 1) age at the time of injury, 2) injured site, 3) the area of accident, 4) the kind of vehicle, 5) associated injuries, 6) methods of treatment for soft tissue reconstruction and 7) complications. The relationships between the area of accident and associated injuries, and the kind of vehicle and associated injuries were analyzed using Chi-square test and Fisher exact test. Results: There were 97 children who were 15 year and younger. The mean age was 7.4 years, and 65% were boys. The left foot was more dominant side of injury (57%). Seasonal variation was seen with the number of injuries peaking during the summer (43%, p<0.05). Among the vehicles, 78.3% were the large vehicles (bus, truck or van). The where of accident was more frequent at an alley or less than two lanes of traffic. But, the relationships between the place of accident and associated injury or the kind of vehicles and associated injury were not statistically significant. The associated injury were fracture or dislocation (23 cases, 35.9%), injury of tendon (21 cases, 32.8%). There were amputation or disarticulation of foot in 8 cases (8.2%) and post-traumatic deformities such as flatfoot, hindfoot varus or valus deformities by tendon injury in 7 cases (7.2%). Conclusion: More than 50% of crushing or degloving injuries of child's foot by traffic accidents happened in boys between 5 to 9 years old. The associated injury was unrelated with size of vehicles or accident place at the time of accident. But, even though foot injury happened in an alley or one lane by small vehicles, child who hurt feet by car need thorough investigation about associated injury. If a surgeon keep in mind and treat child to associated injury necessarily, can minimize complication. Microsurgical reconstruction for soft tissue defect was prior to other methods.

• The Korean Journal of Pain
• /
• v.7 no.1
• /
• pp.96-99
• /
• 1994

Causalgia is a symptom complex usually consisting of burning pain, hyperesthesia and atrophy of the involved extremity. The pain may be aggravated by contact, motion of extremity or emotional excitement. It occurs following incomplete nerve injury. The patient was a 58-year-old male with a 3-year history of causalgic pain of left lower extremity. He had multiple fractures with degloving injury of left lower extremity in an automobile accident. The pain was exacerbated by movement, and he experienced knee joint and ankle joint contracture. The patient's pain decreased after continuous epidural block with 1% lidocaine and 0.25% bupivacaine. He also received lumbar sympathetic ganglion alcohol block resulting in much improvement of level of pain and walking disturbance.

• Journal of Trauma and Injury
• /
• v.34 no.1
• /
• pp.61-65
• /
• 2021

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

• Journal of Trauma and Injury
• /
• v.34 no.1
• /
• pp.75-78
• /
• 2021

A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.