title: Treatment of Foot Degloving Injury With Aid of Negative Pressure Wound Therapy and Dermal Regeneration Template.
abstract: Degloving injury of the foot continues to be a challenging condition to treat. Despite current advancements in reconstructive options, most of these injuries can result in amputations, causing physical and emotional impairment. Few reports have been published on the management of these complex traumatic injuries. Typical reconstruction options have included skin grafting and reattachment of the avulsed skin. Many treating physicians have encountered challenging issues in predicting tissue viability, knowing the extent of the injury, and making a logical decision for limb salvage procedures. The present report provides an algorithm of our approach in managing degloving injuries. A case of foot degloving injury, treated by serial surgical operations with the dominant aim of salvaging the avulsed tissue, is presented. The avulsed portion of the foot, with no identifiable vessels for microsurgical reattachment, was defatted and used as a full-thickness skin graft. Negative pressure wound therapy and a dermal regeneration template were used as adjunct techniques to help obtain good soft tissue coverage. The traditional treatment methods for degloving injuries and the applications of new wound care technologies are discussed.
authors.affiliation: Assistant Professor, Department of Head and Neck Surgery/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, NY. Electronic address: cemile.ozturk@roswellpark.org.
authors.forename: Cemile Nurdan
authors.initials: CN
authors.lastname: Ozturk
authors.affiliation: Family Practitioner, Nashville, TN.
authors.forename: Praise
authors.initials: P
authors.lastname: Opara
authors.affiliation: Academic Clinical Associate, Department of Head and Neck Surgery/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Can
authors.initials: C
authors.lastname: Ozturk
authors.affiliation: Plastic Surgeon, Department of Plastic Surgery, Institute of Dermatology and Plastic Surgery, Cleveland Clinic, Cleveland, OH.
authors.forename: Risal
authors.initials: R
authors.lastname: Djohan
mesh_terms: D062088:Acellular Dermis; D000368:Aged; D000465:Algorithms; D020405:Dermis / Q000502:physiology*; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy; D012038:Regeneration; D012867:Skin / Q000293:injuries / Q000503:physiopathology; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D014945:Wound Healing
keywords: avulsion; fascia; lower extremity; skin; trauma; wound vacuum