Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team.
OBJECTIVE
to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.


METHODS
we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.


RESULTS
there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).


CONCLUSIONS
based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.
Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.
Daniel Francisco
DF
Mello
Serviço de Emergência, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.
José Cesar
JC
Assef
Serviço de Emergência, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.
Sílvia Cristine
SC
Soldá
Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.
Américo
A
Helene
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000069836:Degloving Injuries / Q000601:surgery*; D005121:Extremities / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation; D013997:Time Factors; D060726:Torso / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult