In contrast to open degloving injury, extensive closed internal degloving injury (CIDI) is rare, especialy followed by deep injury with bone-articular and neurovascular complications after initial trauma.1-3 Clinically, it 05- be misdiagnosed or mismanaged leading to delayed full-thickness necrosis of the avulsed skin flap and development of wound sepsis, 3 even limbs disability.4 A number of reports have advocated several means for treatment of CIDI1,3,5,6 but they are not ideal.1,6,7 Since 1987 we have treated 132 degloving injuries, 18 (13.6%) of whom were CIDI in the peripelvis and lower limbs. According to the severity of CIDI, it has been managed by replantation of defatted full-thickness degloved skin with refined techniques as salvage procedures for the avulsed skin, and defect coverage with several myocutaneous flaps for denuded wound of specialized areas. Our purpose is to stress the importance of simultaneous management of both CIDI and deep injury and proper options of resurface procedures to provide better appearance and function of limbs.
展开▼
