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  
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*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
*Often related to other severe injuries, including neurovascular damage, so the degloved tissue is often nonviable
 
 
*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
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**Delayed diagnosis can lead to full-thickness necrosis, or even [[necrotizing fasciitis]]
  
 
==Clinical Features==
 
==Clinical Features==
 
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*Soft tissue loss of varying degrees
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**Limited loss with abrasion/avulsion
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**Non-circumferential
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**Circumferential in single plane
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**Circumferential multiplane
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*Often related to other severe injuries, including neurovascular damage
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**Avulsed tissue is often nonviable
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
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{{Extremity trauma DDX}}
 +
{{SSTI DDX}}
  
 
==Evaluation==
 
==Evaluation==
 
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*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>
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*Assess distal neurovascular function
  
 
==Management==
 
==Management==
 
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*Surgical consult- will need debridement/repair and eventual skin grafting in OR
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*Antibiotics
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**[[Cefazolin]]
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*Resuscitation with IVF/blood products
  
 
==Disposition==
 
==Disposition==
 
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*Admit
  
 
==See Also==
 
==See Also==
 
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*[[Morel-Lavallée Lesion]]
  
 
==External Links==
 
==External Links==
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==References==
 
==References==
 
<references/>
 
<references/>
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[[Category:Trauma]]

Latest revision as of 06:11, 6 April 2018

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

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

Skin and Soft Tissue Infection

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

  1. 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.
  2. 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.