Degloving injury

Background
  • Severe avulsion injury resulting in skin and subcutaneous fat separating from the underlying tissues [1]
  • Can present on any part of the body, but most commonly affects lower extremities
  • Important to recognize quickly, as they are often associated with high morbidity/mortality

Clinical Features
  • Soft tissue loss of varying degrees
    • Limited loss with abrasion/avulsion
    • Non-circumferential
    • Circumferential in single plane
    • Circumferential multiplane
  • Often related to other severe injuries, including neurovascular damage
    • Avulsed tissue is often nonviable

Differential Diagnosis

Extremity trauma

Skin and Soft Tissue Infection

Look-A-Likes

Evaluation
  • Clinical diagnosis, but important to assess for concomitant injuries[2]
  • Assess distal neurovascular function

Management
  • Surgical consult- will need debridement/repair and eventual skin grafting in OR
  • Antibiotics
  • Resuscitation with IVF/blood products

Disposition
  • Admit

See Also


References
  1. Latifi R, El-Hennawy H, El-Menyar A, et al. The therapeutic challenges of degloving soft-tissue injuries. Journal of Emergencies, Trauma, and Shock. 2014;7(3):228-232. doi:10.4103/0974-2700.136870.
  2. Latifi R, El-Hennawy H, El-Menyar A, et al. The therapeutic challenges of degloving soft-tissue injuries. Journal of Emergencies, Trauma, and Shock. 2014;7(3):228-232. doi:10.4103/0974-2700.136870.
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