Degloving Injuries – Types, Complications And How To Treat Them
What Is Degloving?
Degloving Injuries – A degloving, may also be called an avulsion, is a serious injury that occurs when the top layer of skin. The tissue separates from the underlying muscle, connective tissue, or bone. It can affect any part of the body, but it most commonly affects the legs.
These are usually fatal. This is due to massive blood loss and tissue death. Read on to learn more about these types and how to treat them.
Types Of Degloving?
There are two main kinds. They are known as open and closed degloving.
Open Degloving
When skin and tissue flake off to expose muscle, bone, or connective tissue, this is known as open degloving injury. In some cases, the skin may still be partially attached as a flap near the wound.
Injuries during open degloving are usually caused by:
- Traffic Accidents
- Accidents occur due to industrial or farm equipments
- Falls from heights
- Sports injuries
- Animal bites
The most common areas of injury during open degloving are:
- Legs
- Torso
- Scalp
- Face
However, it can affect any part of the body, including fingers, hands, or feet.
Injuries from falling open degloving are serious. They need emergency care to reduce blood loss and prevent infection.
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Closed Degloving
Injuries from closed degloving are not always visible. This makes it difficult for doctors to diagnose them. In some cases, they can cause bruising, but this is usually the only visible symptom.
A 2017 study found that up to one-third of people with injuries sustained while removing closed degloving may be diagnosed late.
Many closed degloving injuries involve forces that separate the top layer of skin and tissues from deeper tissues, leaving space under the skin. This space is known as the Morel-Lavallée lesions. Lesions may fill with lymph fluid, blood, and fat.
Although they look different, injuries caused by a closed degloving are caused by the same accidents as injuries caused by open degloving injuries.
Closed degloving injuires most commonly occur at the top of the femur in an area called the greater trochanter. According to a 2017 review, about 60% of these injuries involve the greater trochanter. Other common areas include:
- Torso
- Buttocks
- Lower spine
- Shoulder blades
- Knees
Most physicians diagnose gloved injuries using MRI, which can detect Morel-Lavallée lesions.
How is it treated?
Treatment for degloving injuries depends on the type, severity, and location of the injury. They are also often accompanied by other serious injuries, such as broken bones, which require emergency treatment.
The availability of advanced trauma care is also an important consideration. Not all emergency centers may be experienced in complex skin repair.
Open Degloving Injuries
Treatment of open degloving injuries depends on the extent of the wound and hospital resources. Not all emergency rooms are equipped to perform complex skin repair surgeries. You may need to be taken to the nearest emergency room for more complex treatment.
Depending on the amount of skin remaining and the type of injury, treatment options may include:
- Re-attachment of the skin
- Skin grafts by using skin from other parts of the body
- Re-attachment of a finger or toe that affects
- Amputation
All of these options generally require some surgery. You may need to stay in the hospital for several days or weeks, depending on the injury. You may also need follow-up physical therapy to regain use of the damaged body part.
In some cases, minor degloving just need a thorough cleaning and a few bandages to help them heal.
Closed Degloving Injuries
Treatment of closed degloving also depends on the extent of the injury. In milder cases, you may just need a combination of compression bandages, physical therapy, and rest.
For more severe cases, treatment options may include:
- Removal of accumulated fluid from the lesion
- Removal of dead tissue
- Sclerotherapy, which involves injecting drugs into blood vessels to make them shrink
Complications
Degloving Injuries are very serious in themselves. But they also carry a high risk of infection because they are often very deep wounds.
To minimize risk, be sure to get emergency medical treatment. So that the wound is absolutely clean. When you recover, tell your doctor if you have any of the following symptoms:
- Red borders around the wound
- Wound swelling
- Drainage around the wound, especially if it is yellow or smells bad
- Fever
- Body Aches
Closed degloving injuries that are not treated may also cause serious tissue death.
The Bottom Line
Degloving Injuries are serious and sometimes may be very fatal. Early treatment is essential to prevent infection. Treatment usually requires a long hospital stay and several surgeries followed by several months of physical therapy.