Degloving injury: Difference between revisions
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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== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[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
- 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
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
- Sporotrichosis
- Osteomyelitis
- Deep venous thrombosis
- Pyomyositis
- Purple glove syndrome
- Tuberculosis (tuberculous inflammation of the skin)
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.