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Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh

Degloving injuries of the upper extremity during work are rare nowadays, because of effective worker protection devices. However, these devastating injuries still occur today during motor vehicle car accidents and surgeons have to be aware of the possibilities of wound coverage for these large, cont...

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Autor principal: Weinand, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Iranian Society for Plastic Surgeons 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290308/
https://www.ncbi.nlm.nih.gov/pubmed/30560080
http://dx.doi.org/10.29252/wjps.7.3.372
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author Weinand, Christian
author_facet Weinand, Christian
author_sort Weinand, Christian
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description Degloving injuries of the upper extremity during work are rare nowadays, because of effective worker protection devices. However, these devastating injuries still occur today during motor vehicle car accidents and surgeons have to be aware of the possibilities of wound coverage for these large, contaminated wounds. We present two cases of degloving injuries of the hand and entire forearm using degloved skin as meshed full thickness skin graft to cover the entire wound. Two patients were admitted to our hospital, presenting large degloving injuries of the entire forearm and hands. Both patients sustained their injuries by being dragged by moving trains and presented additional fractures of the metacarpal bones and in both cases the little finger had to be amputated. The degloved skin was cleansed and meshed as a full thickness skin graft 1:3, using a Brennen Mesher. In both patients, complete wound coverage was achieved using the degloved skin as meshed full thickness skin graft. Attachment to the wound was achieved by vacuum closure device, however, ninety percent of the graft did attach. In both cases, shrinking of the full thickness skin grafts was noted. Both of them received physiotherapy and gained nearly complete function of the injured hand and wrist. When larger parts of skin are lost in degloving injuries meshing the degloved skin as full thickness skin grafts good wound coverage of larger, contaminated defects can be achieved.
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spelling pubmed-62903082018-12-17 Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh Weinand, Christian World J Plast Surg Case Report Degloving injuries of the upper extremity during work are rare nowadays, because of effective worker protection devices. However, these devastating injuries still occur today during motor vehicle car accidents and surgeons have to be aware of the possibilities of wound coverage for these large, contaminated wounds. We present two cases of degloving injuries of the hand and entire forearm using degloved skin as meshed full thickness skin graft to cover the entire wound. Two patients were admitted to our hospital, presenting large degloving injuries of the entire forearm and hands. Both patients sustained their injuries by being dragged by moving trains and presented additional fractures of the metacarpal bones and in both cases the little finger had to be amputated. The degloved skin was cleansed and meshed as a full thickness skin graft 1:3, using a Brennen Mesher. In both patients, complete wound coverage was achieved using the degloved skin as meshed full thickness skin graft. Attachment to the wound was achieved by vacuum closure device, however, ninety percent of the graft did attach. In both cases, shrinking of the full thickness skin grafts was noted. Both of them received physiotherapy and gained nearly complete function of the injured hand and wrist. When larger parts of skin are lost in degloving injuries meshing the degloved skin as full thickness skin grafts good wound coverage of larger, contaminated defects can be achieved. Iranian Society for Plastic Surgeons 2018-09 /pmc/articles/PMC6290308/ /pubmed/30560080 http://dx.doi.org/10.29252/wjps.7.3.372 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Weinand, Christian
Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title_full Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title_fullStr Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title_full_unstemmed Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title_short Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh
title_sort degloving injuries of upper extremity: a strategy with full thickness skin mesh
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290308/
https://www.ncbi.nlm.nih.gov/pubmed/30560080
http://dx.doi.org/10.29252/wjps.7.3.372
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