Degloving · What Is It, Causes, Clinical Presentation, and More

A degloving injury can occur anywhere on the body. However, it most commonly affects the upper or lower extremities. Degloving can lead to open degloving injuries, where the skin, with or without the subcutaneous tissue, is ripped off, exposing the underlying fascia, muscles, and bones. On the other hand, a closed degloving injury, also known as Morel-Lavallee lesion, occurs when the skin layer remains intact despite being separated from the underlying tissue. 

Individuals with degloving injuries often experience pain, swelling, and disfigurement of the affected area. The skin may be completely detached from the body or remain partially attached and hanging near the wound. Some degloving injuries may even cause amputation of fingers or toes.  

Degloving injuries are treated promptly to save the skin and underlying subcutaneous tissue, if applicable, and debride ischemic or necrotic skin. Once a degloving injury is identified, management usually starts with administering IV fluids and antibiotics, such as first-generation cephalosporins (e.g., cefazolin), to minimize the risk of infections.  

For open degloving injuries, the treatment also focuses on covering the tissue that has been degloved. Placing the degloved skin or skin from other body parts can be done through plastic surgery over the wound. A skin graft (i.e., skin transferred without a blood supply) or a skin flap (i.e., skin transferred with its blood supply) can be utilized.  

Severe cases of degloving, where the injury is deep, or there is severe blood loss, can be life-threatening and may require amputation. Closed degloving injuries can be managed with compression bandages if mild or with fluid drainage and removal of dead tissue if more severe.