Understanding Degloving Injuries: Types, Treatment, and Recovery

What is Degloving?

Degloving, also known as avulsion, is a severe injury in which the top layers of skin and underlying tissue are forcibly detached from the deeper muscle, connective tissue, or bone. This injury can occur anywhere on the body but is most frequently seen on the legs. Degloving injuries are often life-threatening due to significant blood loss and extensive tissue damage. Immediate medical intervention is crucial, and antibiotics may be required to prevent infections.

Types of Degloving Injuries

Degloving injuries are classified into two primary types: open degloving and closed degloving.

Open Degloving

• Description: Open degloving involves the separation of the skin and tissue from the underlying muscle, bone, or connective tissue, exposing these deeper structures. Occasionally, the skin may remain partially attached as a flap.

• Causes: Common causes include traffic accidents, machinery or farm equipment mishaps, falls from heights, sports injuries, and animal bites.

• Common Locations: Open degloving typically affects the legs, torso, scalp, and face but can occur on any body part, including fingers, arms, and feet.

• Treatment: Immediate emergency care is required to manage blood loss and prevent infection. Treatment may involve complex procedures such as skin reattachment, skin grafts, or even amputation. Often, patients need to be transferred to a specialized trauma center for advanced care, and recovery may involve multiple surgeries and physical therapy.

Closed Degloving

• Description: Closed degloving injuries are less visible and harder to diagnose. They may only present as bruising, with internal separation of the skin from underlying tissues, creating spaces known as Morel-Lavallée lesions that can fill with lymph fluid, blood, and fat.

• Causes: Closed degloving can result from similar forces as those causing open degloving injuries.

• Common Locations: These injuries are most commonly found around the greater trochanter of the hip, as well as the torso, buttocks, lower spine, shoulder blades, and knees.

• Diagnosis and Treatment: MRI scans are often used to detect Morel-Lavallée lesions. Treatment may include draining accumulated fluid, removing dead tissue, and sclerotherapy to shrink affected blood vessels. For minor cases, compression bandages and physical therapy may suffice.

Treatment and Recovery

The treatment approach for degloving injuries varies based on the injury's type, severity, and location. Open degloving injuries often require specialized trauma care and may involve multiple surgeries and an extended hospital stay. Treatment options include:

• Reattaching the skin

• Performing skin grafts

• Potentially amputating severely damaged parts

• Rehabilitation with physical therapy

Closed degloving injuries may be treated with:

• Fluid drainage

• Dead tissue removal

• Sclerotherapy

• Compression bandages and physical therapy for less severe cases

Potential Complications

Degloving injuries are associated with high risks of infection due to their deep nature. It's essential to seek emergency medical care to ensure the wound is properly cleaned and treated. Be vigilant for signs of infection or complications, such as:

• Redness around the wound

• Swelling

• Discharge, especially if it's yellow or has a foul odor

• Fever and body aches

Closed degloving injuries that go untreated can also lead to severe tissue death.

Outlook

Degloving injuries are serious and may sometimes be fatal. Prompt treatment is crucial to prevent complications and manage the injury effectively. Recovery typically involves a lengthy hospital stay, multiple surgeries, and extensive physical therapy.

Disclaimer: This article is intended for informational purposes only and does not substitute for professional medical advice. For diagnosis and treatment of any medical condition, always consult with a healthcare provider.