Degloving injury: Difference between revisions

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==Background==
==Background==
*Severe avulsion injury resulting in skin and subcutaneous fat separating from the underlying tissues  
*Severe avulsion injury resulting in skin and subcutaneous fat separating from the underlying tissues <ref>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. </ref>
*Can present on any part of the body, but most commonly affects lower extremities
*Can present on any part of the body, but most commonly affects lower extremities
*Often related to other severe injuries, including neurovascular damage, so the degloved tissue is often nonviable
*Important to recognize quickly, as they are often associated with high morbidity/mortality
*Important to recognize quickly, as they are often associated with high morbidity/mortality
**Delayed diagnosis can lead to full-thickness necrosis, or even [[necrotizing fasciitis]]
**Delayed diagnosis can lead to full-thickness necrosis, or even [[necrotizing fasciitis]]


==Clinical Features==
==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==
==Differential Diagnosis==
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==Evaluation==
==Evaluation==
*Clinical diagnosis, but important to assess for concomitant injuries
*Clinical diagnosis, but important to assess for concomitant injuries<ref>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. </ref>
*Assess distal neurovascular function
*Assess distal neurovascular function


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==References==
==References==
<ref>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. </ref>
<references/>
<references/>
[[Category:Trauma]]

Latest revision as of 06:11, 6 April 2018

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

External Links

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.