What is degloving?

Degloving is a type of severe injury where a significant portion of skin and underlying tissue is traumatically separated from the deeper tissues of the body. This separation disrupts the blood supply to the detached tissues, potentially leading to necrosis (tissue death) if not properly treated.

Key aspects of degloving injuries:

Mechanism: Degloving commonly results from high-energy trauma, such as motor vehicle accidents, industrial accidents, or crush injuries. The force causes the skin and subcutaneous tissues to shear away from the underlying fascia, muscles, or bone.
Appearance: The affected area often appears as a large, open wound with the skin hanging loosely or being completely detached. There might be visible pockets or cavities beneath the remaining skin. The area can be severely swollen.
Common Locations: Degloving injuries can occur in various parts of the body, but are commonly seen in the extremities (arms and legs), scalp, and trunk.
Classification: Degloving injuries are often classified based on the extent and depth of the tissue separation. This can influence the treatment approach.
Complications: Major risks include infection, skin necrosis, compartment syndrome, and significant scarring. Long-term functional impairment can also occur.
Treatment: Treatment generally involves surgical intervention. Options include:
- Replantation/Revascularization: Attempting to reattach the degloved skin flap if it is viable and contains sufficient blood supply.
- Skin Grafting: Covering the exposed area with skin taken from another part of the body.
- Flap Reconstruction: Using a flap of skin, fat, and muscle with its own blood supply to cover the defect.
Prognosis: The outcome varies based on the severity of the injury, the promptness of treatment, and the patient's overall health. Extensive degloving injuries may require multiple surgeries and a lengthy recovery period.

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