What is degloving

Definition

Degloving is a catastrophic injury in which skin and soft tissue are stripped away or separated from underlying structures. The term "degloving" derives from the appearance of removed gloves, as the outer skin layer separates intact, exposing raw tissue beneath. These are extremely serious injuries requiring immediate emergency medical attention.

Causes of Degloving Injuries

Degloving typically results from high-impact trauma or crush mechanisms:

• Machinery accidents: Industrial equipment, farm machinery, and manufacturing equipment cause degloving when limbs become caught
• Motor vehicle collisions: High-speed accidents can cause skin stripping through crush or shearing forces
• Crush injuries: Heavy objects falling on or pinning limbs separate tissue layers
• Avulsion injuries: Forces that tear tissue away from its attachments
• Blast injuries: Explosions can cause extensive tissue separation

Types and Severity

Degloving injuries range in severity. Partial degloving involves separation of some skin and tissue, while complete degloving involves total separation of all skin and underlying layers. Open degloving creates obvious wounds, while closed degloving occurs with intact overlying skin but separated deeper tissues, making initial assessment challenging.

Medical Treatment

Degloving injuries require emergency surgical intervention. Initial treatment focuses on stabilizing the patient and preventing infection. Surgical options may include debridement (removal of damaged tissue), reconstruction using skin grafts, tissue flaps, or in severe cases, amputation. Reconstructive surgery aims to restore function and appearance, though complete restoration is often impossible. Treatment is complex and typically requires multiple surgeries over months or years.

Complications and Recovery

Degloving injuries carry significant complications. Infection risk is high due to large exposed tissue areas. Loss of function is common, particularly with hand or limb degloving. Chronic pain frequently develops after injury and recovery. Psychological impact can be severe given the visible nature of injuries and lasting disability. Recovery is lengthy, requiring extensive rehabilitation and psychological support.