Avulsion & Degloving Wounds
What are Skin Avulsion and Degloving Wounds ?
The term “ Skin Tear wounds” refers to wounds, that is caused by shear, friction and /or blunt force resulting in separation of skin layers. A skin tear can be partial thickness (separation of the epidermis from the dermis: Skin Tear Injuries) or full thickness (separation of both the epidermis and dermis from underlying structures: avulsion and degloving injuries)
Avulsion and Degloving Injuries Are the result of a high energy traumatic injury of normal skin 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
What Forms of Skin Tear wounds are there?
Avulsion and Degloving Injuries can be classified into
- Closed degloving injuries (Morel Lavallee Lesion at the hip region)
- Open degloving injuries
Closed degloving injuries
- (Morel Lavallee Lesion at the hip region)
- ……..
Open degloving injuries
- Ring-avulsion injury (“Wedding ring-injury”)
- Lower leg degloving injury
- …..
What are the consequences of Avulsion & degloving wounds?
Avulsion and degloving injuries are serious limb-threatening injuries depending on
- Depth of skin avulsion or degloving (partial thickness, full.thickness)
- Surface of avulsion (i.e. partial/cicumferiential)
- Additional injuries to the involved body region (i.e. open fracture)
When avulsion and degloving wounds are not well identified, their treatment by an inexperienced treatment team results in:
- Prolonged treatment duration with significant impairment of the patient
- Poor treatment outcome
- Increased complication rate, including permanent damage (partial limb amputation)
How can you treat a Avulsion and degloving Wound ?
Avulsion and degloving injuries need immediate admission to a highly specialized Center (Plastic & Reconstructive Surgery). Quality of diagnosis and care and speed of initial management will have an important influence on the final outcome. The better the interdisciplinary cooperation in the trauma team , the lower the amputation rate at the upper and lower limb.
