Degloving Injuries: Types, Causes, Symptoms & Treatment

Accidents and injuries are an unfortunate reality of life, but most are often less impactful and recoverable. However, amongst the range of common and uncommon injuries, the ones that stand out particularly impactful are the Degloving Injuries.

This term is undoubtedly uncommon and unfamiliar to many, but it has a significant physical and mental impact on individuals who experience it. Understanding Degloving Injuries is crucial when navigating the complexity of safety and health. Continue reading the article as it unfolds this topic’s complexity, depth, and diversity. 

What is a Degloving Injury? How To Manage It?

A Degloving Injury is a severe type of trauma and often a life-threatening injury. This traumatic injury usually occurs by forcefully separating the outer skin and underlying tissue from the underlying bones, muscles, and other parts of the structure. The injury got its name ‘De-gloving’ since it removes the outer layer of skin (along with tissue) just like a glove removes from the hand. 

Although it may affect different body parts, it mainly targets the areas with relatively less adherence to the skin. The most commonly targeted areas include lower limbs, especially knees, ankles, hands, and fingers.

Types of Degloving Injuries

Degloving Injuries are categorized as open and closed, although they can be distinguished into a few types. Here’s an overview:

▶ Open Injury

It involves an open wound where the skin is either visibly torn or disrupted. Such type of injury often develops a risk of infection and thus requires careful wound management.

▶ Closed Injury

It separates the skin from the underlying structure; however, the surface remains intact. However, diagnosing such types of injuries is commonly challenging since they are not immediately visible.

▶ Total

It completely separates skin and soft tissues from the structure over a large area. It further results in significant blood loss and a broken blood supply to a particular area.

▶ Partial

It is when only a portion of skin and underlying tissue is detached; however, some areas are still connected.

▶ Avulsion

It refers to the tearing away of skin and tissues due to sheer force, commonly due to high-impact accidents/ incidents.

▶ Crush

A crushing force commonly causes it, thus leaving compression or separating skin and associated machinery.

Causes of Degloving Injuries

• Industrial accidents, particularly the ones involved with heavy machinery and equipment.
• High-impact car accidents/ motor vehicle collisions.
• Slip/ fall from height.
• Crush accidents involving heavy objects or machinery.
• Motorcycle accidents, especially when someone comes in harsh contact with the road.
• Animal bite.

Symptoms of Degloving Injuries

Recognising Degloving injuries’ signs (and symptoms) is essential for timely medical care. Here are some of the key indicators to know about:

• The most obvious sign is the visible separation of skin from its underlying structure.
• Another common sign is bruising and swelling of the affected area, commonly due to trauma and disruption of blood vessels.
• Tenderness and Pain.
• Limited or no range of motion in the affected body part.
• Exposed bones, muscles, and other underlying structures.
• Paleness or bluish skin due to reduced blood supply to that particular area.
• Numbness of tingling sensation.
• Symptoms of shock include shallow breathing, rapid heartbeat, confusion, and more.

Immediate First Aid and Emergency Response

When dealing with Degloving injuries, providing first aid within emergency response is essential. Here’s an overview of the same:

• Firstly, dial emergency medical help as the first response.
• Access the ongoing accident spot and try to move the injured individuals to a safer location (if required).
• Encourage the wounded individual to remain still, as it is essential to prevent further damage.
• Use a sterile bandage to control any visible bleeding with gentle pressure and avoid any excessive pressure.
• Cover the wound with a non-stick bandage to protect it from contamination.
• Elevate the injured limb to minimize blood flow and reduce swelling.
• DO NOT touch the wounded area, as doing so may lead to infection.
• DO NOT try to reattach the skin since it is a complicated procedure.
• Try to calm the injured individual emotionally, especially if they show any signs of shock.

Medical Treatment Options

Treating Degloving injuries often involves a highly professional approach under a regulated medical environment. Here’s an overview of the same:

• The doctor (team of professionals) may begin by removing the damaged or contaminated tissue to prevent infection and promote healing.
• Pain relief medicines to manage the discomfort associated with the injury and medical procedure.
• The treatment further may involve a combination of (or standalone) these medical procedures:
• Skin grafting is used to transplant healthy skin from one area of the body to another location, especially to cover the injury.
• Flap reconstruction/ usage of tissue flaps to restore blood supply and cover the affected area.
• Vascular repair procedure to restore blood flow and prevent complications.
• Surgical procedure for repairing nerves or for reconnecting the damaged nerves.
• Orthopedic procedures if bones were involved in the injury.
• Infection management with antibiotics.
• Lastly, follow-up care is needed to monitor the healing process.

Are they Painful?

Yes, Degloving injuries can be extremely painful, sometimes beyond an individual’s tolerance level. However, the severity of the pain may depend upon the extent of the injury.

Meanwhile, the medical procedure is comparatively less painful but can cause discomfort. If any surgical procedures are involved, it may cause postoperative pain.

How long does it take to recover?

The recovery time is longer; however, it widely depends upon various factors. Minor degloving injuries with minimal tissue involvement may take several weeks for recovery. At the same time, moderate to severe injuries may take several weeks to months, and even rehabilitation for complete recovery. However, since every case is unique, each timeline will vary.

Bottom Line

Overall, Degloving injuries are severe trauma, and thus, they need immediate medical care. Since they can sometimes prove fatal, it is crucial to report them to the nearest and appropriate healthcare, especially if the individual is in a state of shock.

Although there is no way of treating these injuries at first aid, trying to (if possible) reduce the bleeding and comforting the individual is extremely necessary. 

However, despite how alarming the situation can be, most of these injuries have a ray of recovery under arduous and advanced medical treatments. 

References

• National Institute Of Health(2023) Degloving Injuries available online at: https://www.ncbi.nlm.nih.gov/books/NBK557707/
• National Institute Of Health(2011) Degloving injuries of the hand available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193635/