The degloving injuries of the digits and palm remain a persistent challenge. We used an anterolateral thigh flap to treat an 18-year-old, right-handed male worker with degloving injuries of the index, middle and ring ...The degloving injuries of the digits and palm remain a persistent challenge. We used an anterolateral thigh flap to treat an 18-year-old, right-handed male worker with degloving injuries of the index, middle and ring fingers. The flap was designated to wrap the entire circumference of three fingers sustaining degloving injury and to form mitten-hand. The total lengths of the distal phalanxes of three fingers were retained almost complete. The donor defect was covered with split-thickness skin graft. Three months after the first operation, roentgenograms revealed terminal phalanxex resorption in three injured fingers, and the surgical syndactyly between the middle and ring finger was separated at the same time. One month later, the syndactyly between the index and middle fingers was also separated. Good coverage of the soft tissue defects with good function and appearance was achieved. Therefore, we considered that the length of the degloved finger could be preserved using free flap.展开更多
In contrast to open degloving injury, extensive closed internal degloving injury (CIDI) is rare, especialy followed by deep injury with bone-articular and neurovascular complications after initial trauma.1-3 Clinicall...In contrast to open degloving injury, extensive closed internal degloving injury (CIDI) is rare, especialy followed by deep injury with bone-articular and neurovascular complications after initial trauma.1-3 Clinically, it 05- be misdiagnosed or mismanaged leading to delayed full-thickness necrosis of the avulsed skin flap and development of wound sepsis, 3 even limbs disability.4 A number of reports have advocated several means for treatment of CIDI1,3,5,6 but they are not ideal.1,6,7 Since 1987 we have treated 132 degloving injuries, 18 (13.6%) of whom were CIDI in the peripelvis and lower limbs. According to the severity of CIDI, it has been managed by replantation of defatted full-thickness degloved skin with refined techniques as salvage procedures for the avulsed skin, and defect coverage with several myocutaneous flaps for denuded wound of specialized areas. Our purpose is to stress the importance of simultaneous management of both CIDI and deep injury and proper options of resurface procedures to provide better appearance and function of limbs.展开更多
文摘The degloving injuries of the digits and palm remain a persistent challenge. We used an anterolateral thigh flap to treat an 18-year-old, right-handed male worker with degloving injuries of the index, middle and ring fingers. The flap was designated to wrap the entire circumference of three fingers sustaining degloving injury and to form mitten-hand. The total lengths of the distal phalanxes of three fingers were retained almost complete. The donor defect was covered with split-thickness skin graft. Three months after the first operation, roentgenograms revealed terminal phalanxex resorption in three injured fingers, and the surgical syndactyly between the middle and ring finger was separated at the same time. One month later, the syndactyly between the index and middle fingers was also separated. Good coverage of the soft tissue defects with good function and appearance was achieved. Therefore, we considered that the length of the degloved finger could be preserved using free flap.
文摘In contrast to open degloving injury, extensive closed internal degloving injury (CIDI) is rare, especialy followed by deep injury with bone-articular and neurovascular complications after initial trauma.1-3 Clinically, it 05- be misdiagnosed or mismanaged leading to delayed full-thickness necrosis of the avulsed skin flap and development of wound sepsis, 3 even limbs disability.4 A number of reports have advocated several means for treatment of CIDI1,3,5,6 but they are not ideal.1,6,7 Since 1987 we have treated 132 degloving injuries, 18 (13.6%) of whom were CIDI in the peripelvis and lower limbs. According to the severity of CIDI, it has been managed by replantation of defatted full-thickness degloved skin with refined techniques as salvage procedures for the avulsed skin, and defect coverage with several myocutaneous flaps for denuded wound of specialized areas. Our purpose is to stress the importance of simultaneous management of both CIDI and deep injury and proper options of resurface procedures to provide better appearance and function of limbs.
