Degloving injuries are often life-threatening and require immediate medical attention.A degloving injury is a traumatic injury that results in the top layers of skin and tissue being torn away from the underlying muscle, connective tissue or bone. They most commonly affect the legs and are frequently associated with underlying fractures. Because they typically involve severe blood loss and tissue death, they are often life-threatening.
Causes of Degloving Injuries
Degloving injuries are often associated with accidents involving industrial or farm equipment, but there are several other potential causes, including:
- Motorcycle accidents
- Car accidents
- Sports mishaps
- Animal bites
- Falls from heights
- Construction accidents
Types of Degloving Injuries
When the skin and tissue are ripped away and the muscles and bones underneath are exposed, this is characterized as an open degloving injury. In some cases, the skin may still be partially attached and hanging as a flap near the wound.
A closed degloving injury is a bit more complicated, as the top layer of skin remains intact even though it has been separated from the tissue underneath it. Closed degloving injuries often occur at the top of the hip bone but can also affect the torso, buttocks, lower spine, shoulder blades and knees.
Diagnosis of Degloving Injuries
Determining the extent of a degloving injury can be difficult, as simply visually assessing the degloved skin might not reveal the full extent of the injury. Determining skin viability is also difficult when using subjective criteria such as bleeding, skin color, skin temperature and pressure reaction.
Open degloving injuries are easier to diagnose, as muscle and bone will be exposed where the skin has been ripped away. Closed degloving injuries are harder to identify, as it may not be obvious that the top layer of skin has detached from deeper layers of tissue. Symptoms to look for include bruising, pain and swelling in the affected area.
Treatments for Degloving Injuries
The treatment options for a degloving injury depend on its severity and location, and whether broken bones are also present. Not all hospitals can provide complex skin repair, so patients sometimes need to be transferred to nearby trauma centers, like Tampa General Hospital.
For open degloving injuries, treatment may include:
- Skin reattachment
- Reattachment of fingers or toes
- Skin grafts
For closed degloving injuries that are less serious, treatment may involve a combination of compression bandages and physical therapy. For more serious cases, fluid might need to be drained from the lesion and dead tissue may need to be removed. The patient may also undergo injections into blood vessels to help them shrink.
Tampa General Hospital is a Level I Trauma Center and provides treatment to adult and pediatric patients suffering from a wide array of conditions. TGH has earned national Level I Trauma Center verification from the American College of Surgeons (ACS)—the first hospital in Florida to do so.