scholarly journals Morel-lavallee lesion – a Hidden degloving injury

Author(s):  
Javed Hussain
Keyword(s):  
2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Tae Nagama ◽  
Natsuko Kakudo ◽  
Atsuyuki Kuro ◽  
Yujiro Ozaki ◽  
Yasuko Shirasawa ◽  
...  

Abstract Degloving, a skin and subcutis avulsion, is a severe traumatic injury sometimes caused by rolling wheels or machines. Although avulsed flaps are often readapted to its original site, most of these tissues become necrotic. Due to the extensive skin and soft tissue deficiency caused by necrosis, treatment becomes difficult. Skin grafts harvested from avulsed flaps may be used to treat degloving injuries, while negative pressure wound therapy (NPWT) is used to secure the grafts. Commonly used porous polyurethane foam wound fillers are difficult to set in circumferential extremity degloving injuries; gauze-based wound fillers are easier to use and cause less pain during dressing changes. We present a case of an extensive, full-circumference left lower-extremity degloving injury, treated using NPWT with gauze-based wound fillers for fixation of skin grafts harvested from avulsed flaps after hydrosurgical debridement. For complex wound geometries, gauze-based wound fillers can be easily applied for skin graft immobilization.


Injury Extra ◽  
2007 ◽  
Vol 38 (5) ◽  
pp. 187-192 ◽  
Author(s):  
Thomas Zgonis ◽  
Douglas T. Cromack ◽  
Thomas S. Roukis ◽  
Joann Orphanos ◽  
Vasilios D. Polyzois

2010 ◽  
Vol 17 (01) ◽  
pp. 44-49
Author(s):  
TAJAMMAL ABBAS SHAH ◽  
USMAN LATIF ◽  
QUDDUS-UR- REHMAN

The alarming rise in road traffic accident has resulted in increased incidence of degloving lower limb injuries requiring some sortof cover for exposed bones e.g tibia. Objective: To study and compare the rate of wound infection & decreased morbidity in degloving injuriesof lower limb following early bone coverage by various surgical methods of bone coverage. Design: Comparative, prospective study, Place& duration of study. Allied Hospital SU II Faisalabad. Period: From January 2002 to October 2004. Material & Methods: Thirty (30) patientsdivided into four groups, muscle & musculocutaneous flaps for 15 patients, local rotational flaps for 05 patients, cross leg flaps & decorticationfor 05 patients. The patients in each group were divided unequally because of unavailability of patients. Patients were also examinedpostoperatively for 06 weeks. Results: The patients underwent surgery for degloving injury of leg. Most of them were young malesbetween 5-45 years of age resulting mainly from different types of accidents. 2 out of 15(13.3%) patients having, musculocutaneous flapsdeveloped wound infection. 1 out of 5(20%) with local rotational flaps, 2 out of 5 (40%) with cross leg flaps & 3 out of 5(60%) with decorticationdeveloped wound infection. 14 out of 15(93.3%) patients with muscle & musculocutaneous flaps while 4 out of 5(80%) with local rotational flapsrecovered within 3 weeks. Patients with cross leg flaps recovered after one month while patients with decortication recovered after forty fivedays. 13 out of 15 regained full function (86%) with muscle & musculocutaneous flaps while patients having local rotational flaps regained 100%full function. 4 out of 5(80%) regained full function with cross leg flaps & 1 out of 5(20%) regained full function with decortication. Conclusions:Muscle & musculocutaneous flaps for exposed tibia is safe and effective method of treatment having low rate of wound infection with widercoverage & decreased morbidity.


2019 ◽  
Vol 48 (3) ◽  
pp. 303-306 ◽  
Author(s):  
Alexandros Kyriakidis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Michael S. Green ◽  
Daniel Wu ◽  
Vishal Patel ◽  
Rayhan Tariq

Transcutaneous lead extraction can be associated with significant morbidity and mortality. The risk of causing concomitant arterial and venous injury is rare. We report a case of marginal artery rupture with coronary sinus rupture after a CS lead extraction. A 71-year-old male was admitted for extraction of a 6-year-old implantable cardioverter-defibrillator lead due to fracture from insulation break. During the lead extraction, blood pressure fell precipitously and echocardiographic findings were consistent with pericardial effusion. After unsuccessful pericardiocentesis, open chest sternotomy and evacuation of hematoma was performed. Subsequent surgical repair of several injuries was completed including the distal coronary sinus, a large degloving injury of posterior portion of the heart, and first obtuse marginal branch bleed. This case demonstrates that when performing transcutaneous lead extraction (TLE) with laser sheath, a degloving injury can cause arterial rupture with concomitant coronary sinus injury. A multidisciplinary team-based approach can ensure patient safety.Learning Objective.Implantable cardioverter-defibrillator leads will falter over time. With the advancement of new technology for extraction more frequent and serious complications will occur. Active fixation CS leads present unique challenges. In the presence of hemodynamic changes during extraction the occurrence of both an arterial and venous injury must be considered.


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