Degloving injuries are severe traumas that result in the separation of the skin and subcutaneous tissue from the underlying structures, such as muscles, bones, and blood vessels. These injuries are often associated with high-impact accidents, and they can have devastating consequences for the affected individuals.
In this article, we will delve into the details of the injuries by exploring their causes, symptoms, and available treatment options.
Understanding Degloving Injuries
Degloving is categorized into two main types, here there are:
1. Open Degloving Injuries
Open degloving refers to the situation where the skin and tissue are forcibly torn away, revealing muscle, bone, or connective tissue. In some instances, the skin may still be partially attached as a flap near the wound.
The body areas most frequently affected by this type of injury are the legs, torso, scalp, and face, although any part, including fingers, arms, or feet, can be impacted. This type is serious and demands immediate medical attention to minimize blood loss and prevent infection.
2. Closed Degloving Injuries
On the other hand, the closed one may not be readily visible, posing a challenge for doctors in terms of diagnosis. In some cases, the only apparent symptom is a bruise.
This type typically involves a force that separates the outer layer of skin and tissue from deeper tissues, creating a space under the skin known as Morel-Lavallée lesions. These lesions can accumulate lymph fluid, blood, and fat.
Despite their distinct appearance, the closed degloving injuries stem from the same accidents that lead to open injuries. This injury is often located at the top of the hip bone in the greater trochanter region, with approximately 60 percent of such injuries involving this area. Other commonly affected areas include:
- torso,
- buttocks,
- lower spine,
- shoulder blades,
- knees.
Diagnosis of closed degloving injuries is commonly performed using an MRI scan, which can detect Morel-Lavallée lesions.
Causes of Degloving Injuries
Degloving can occur when a body part becomes entangled and forcefully separated, causing the skin and underlying soft tissue to detach.
Examples of situations leading to this injury include forcibly removing a ring from a finger, having a foot run over by a tire, experiencing a sports-related accident, or being involved in an industrial or farm equipment mishap. Further, this injury typically results from:
- Falls from elevated places
- Sports-related injuries
- Automobile, bicycle, or motorcycle accidents
- Accidents involving heavy machinery like farm equipment or conveyor belts
- Animal bites or attacks
- Forceful removal of rings from fingers
The Appeared Symptoms
Identifying degloving injuries early is crucial for prompt and effective treatment. The symptoms you experience will vary depending on the type and severity of your degloving injury. The following symptoms are indicative of a degloving injury:
- Intense pain
- Profound lacerations or open wounds
- Exposure of bone, muscle, tendons, nerves, or connective tissue
- Significant blood loss
- Complete or partial separation of the skin
- Tissue necrosis
- Shock
- Pain
- Bruising and skin discoloration
- Swelling
- Sensitivity
- Dry, cracked skin
Treatment Options
Treatment of this injury is complex and requires a multidisciplinary approach. The primary goals of treatment are to restore blood flow, promote wound healing, and reconstruct the affected area. The treatment approach for degloving injuries is contingent upon the injury’s type, severity, and location.
Additionally, these injuries often coincide with other serious conditions, such as fractures, necessitating immediate medical attention. The availability of advanced trauma care also plays a crucial role, as not all emergency facilities may possess the expertise required for intricate skin repair.
1. Open Degloving Injuries Treatment
The treatment of open injury is determined by the extent of the injury and the resources available at the hospital. Not all emergency rooms are equipped for complex skin repair, and patients might need to transfer to a nearby trauma center for more advanced care.
Depending on the remaining skin and the nature of the injury, treatment options may involve:
- Reattaching the skin
- Skin grafts using tissue from other body parts
- Reattachment of a finger or toe
- Amputation
These options generally entail multiple surgical procedures, and the recovery period may require days or weeks in the hospital. Follow-up with physical therapy may be necessary to regain functionality in the affected body part. In certain instances, minor degloving injuries may only require thorough cleaning and bandaging for healing.
2. Closed Degloving Injuries Treatment
The treatment of closed injury also hinges on the extent of the injury. In less severe cases, a combination of compression bandages, physical therapy, and rest may suffice. For more severe cases, treatment options may involve:
- Removing necrotic tissue
- Draining accumulated fluid from the lesion
- Sclerotherapy, which is a procedure that entails injecting blood vessels with medication to induce shrinkage.
Potential Complications
Degloving injuries pose a significant threat due to their severity and the heightened risk of infection associated with their deep nature. To minimize this risk, it is crucial to seek immediate medical attention for thorough wound cleaning. It is important to communicate with your doctor if you experience any of the following symptoms:
- Red-colored edges surrounding the wound
- Swelling of the wound
- Oozing around the wound, particularly if it appears yellow or has an unpleasant odor
- Fever
- Body aches
- Infection
- Compartment syndrome (painful pressure buildup in muscles)
- Osteomyelitis (bone infection)
- Lymphedema (accumulation of lymph fluid under the skin)
- Contracture (muscle shortening and hardening)
- Nerve damage
- Death
For individuals with degloving injuries, the anticipated long-term effects vary based on the injury’s severity. Scarring or residual signs of the injury are likely, and a protracted healing process, involving physical therapy, rehabilitation, and ongoing care from a medical professional, may be necessary.
Additionally, there is a possibility of losing functionality in the injured body part. While early treatment is crucial for this injury, complications may still arise and lead to potential long-term effects.
Understand Degloving Injuries and Get Your Best Treatment!
Degloving injuries are serious and often result from high-impact accidents. Understanding the causes, recognizing symptoms, and seeking prompt medical attention is critical for successful treatment and recovery.
The collaboration of medical professionals across various specialties is essential to address the complex nature of this injury and provide comprehensive care to those affected. Prevention through safety measures in high-risk environments remains a key aspect of minimizing the occurrence of these devastating injuries.
