Difference between revisions of "Degloving injury"
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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 | ||
| − | |||
*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]] | ||
==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== | ||
| − | + | {{Extremity trauma DDX}} | |
| + | {{SSTI DDX}} | ||
==Evaluation== | ==Evaluation== | ||
| − | + | *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 | ||
==Management== | ==Management== | ||
| − | + | *Surgical consult- will need debridement/repair and eventual skin grafting in OR | |
| + | *Antibiotics | ||
| + | **[[Cefazolin]] | ||
| + | *Resuscitation with IVF/blood products | ||
==Disposition== | ==Disposition== | ||
| − | + | *Admit | |
==See Also== | ==See Also== | ||
| − | + | *[[Morel-Lavallée Lesion]] | |
==External Links== | ==External Links== | ||
| Line 28: | Line 39: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
| + | |||
| + | [[Category:Trauma]] | ||
Latest revision as of 06:11, 6 April 2018
Contents
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
- Delayed diagnosis can lead to full-thickness necrosis, or even necrotizing fasciitis
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
- Compartment syndrome
- Contusion
- Crush syndrome
- Degloving injury
- Fracture
- Laceration
- Myositis ossificans
- Open joint injury
- Peripheral nerve injury
- Rhabdomyolysis
- Tendon injury
- Vascular injury
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
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
- ↑ 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.
- ↑ 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.