Revascularization of degloving injuries of the limbs

Between 1990 and 1994 a study was carried out of 32 patients who had degloving injuries of the limbs. There were three types of injuries: type I, nine patients with severely damaged skin and subcutaneous tissue; type II, 13 patients whose skin and subcutaneous tissue were moderately damaged, but subcutaneous veins were still identifiable; and type III, 10 patients whose skin and subcutaneous tissue were moderately damaged and venous back flow was observed. The patients in type I were treated by extensive debridement and the flaps were used for free full and split thickness skin grafting. In type II, arterialization of the venous system of the flaps was performed and successful perfusion was observed in nine patients. In type III, venous anastomoses were performed and all had good results. Revascularization of the flaps in types II and III degloving injuries of the limbs gave good results. The raw surface which needed skin grafting was minimized and the course of treatment and morbidity were decreased.