Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 9 , ISSUE 1 ( January-April, 2020 ) > List of Articles

Original Article

Truncal Degloving Injuries: A Marker of Distinct Morbidity and Mortality

Fernando Antonio Campelo Spencer Netto, Mariana J Becker, André Pereira Westphalen, Allan Cezar Faria Araujo

Keywords : Degloving injuries, Multiple trauma, Wounds and injuries

Citation Information : Netto FA, Becker MJ, Westphalen AP, Araujo AC. Truncal Degloving Injuries: A Marker of Distinct Morbidity and Mortality. Panam J Trauma Crit Care Emerg Surg 2020; 9 (1):49-55.

DOI: 10.5005/jp-journals-10030-1271

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Traumatic degloving injuries consist of detachment of skin and subcutaneous tissue from the underlying fascia and muscles due to high-energy shearing forces. Open degloving injuries of the torso are poorly described, have many different presentations, and their full extension is difficult to assess. This article aims to describe this patient population (soft tissue injuries, associated trauma, treatment particularities, morbidity, and mortality), alerting emergency surgeons to this entity. Materials and methods: This study is a case series of blunt trauma patients presenting open degloving injuries of the torso. After institutional research and ethics board approval, data were collected through electronic medical records at the Hospital Universitário do Oeste do Paraná, Cascavel–Paraná, Brazil. The degloving injuries were classified according to the involved torso segment. The treatment of the degloved area was divided as contamination control, infection and ischemia control, and reconstruction techniques. The data were organized and displayed in tables and text. Results: Six patients were identified, with age of 36.5 ± 7.5 years, and injury severity score (ISS) of 31.3 ± 16.7. All presented hypovolemic shock on admission and shearing forces as trauma mechanism. In four patients, degloved area involved pelvis/perineum, one patient injured the anterior wall of the abdomen, and one the back of thoracolumbar area. All patients had associated injuries. The number of surgeries for treatment of soft tissue injuries was 5.1 ± 2.6. Hospital stay was an average of 40.2 days. Two patients died. Conclusion: Patients with open degloving injury of the torso have high ISS. Morbidity and mortality may occur due to the associated lesions or soft tissue lesions. Surgery requirements, the high number of procedures, and long hospital length of stay reinforce the complexity of the treatment and the need for adequate therapeutic planning.


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