The Pathophysiology of Wound Healing from Leg Degloved

Introduction:

The patient has a leg wound on her left leg that she got from a fall and it was considered "degloved"

We will define what a degloved is, the signs and symptoms of this and how to diagnose it with labs and radiology etc and lastly the Pathophysiology of Wound Healing.

1. Definition of Degloved - is a forced separation or tearing away of a large piece of skin and  soft tissue caused by a serious injury. The skin is ripped off like removing gloves

 2. Manifestation or Signs and Symptoms-   - bruising, extreme pain the left leg wound area,  swelling on the wound

3. Diagnosis-  Degloving of skin or soft tissue is hard to diagnose, the patient that has a degloved left leg wound may undergo  the following

• intravenous fluorescein for better assessment method.

• Skin color, skin temperature, pressure reaction in the area will be examined.

• Bleeding or lack of bleeding  may be closely monitor to examine the tissue.

• CT scan and MRI are good choices for evaluating the severity of the wound.

4.Potential complication:

  Since this is an open wound it may lead to infection. 

5. Medical and surgical collaborative intervention

For this patient the severity of the wound is not mentioned  although 4×7 inches wound is a long wound. Depending on the amount of skin that is left in the area doctors may reattach the skin or patient may undergo skin grafting taken from a donor site.

 6. How will it affect the patient life?

This injury is very painful. The patient may undergo a long process of healing and treatment, and may need thorough care and close monitoring from the doctor to ensure the wound is healing properly. Most probably it may leave a scar on the left leg.

  7. Pathophysiology of wound healing - Patient may have skin reattachment following the degloved skin. It may be efficient to cover the open wound.  The ripped skin may sewn back to its original form. The patient that may  underwent skin grafting may stay in the hospital for few days to ensure the skin graft is healing well. The skin graft may produce blood vessels and connecting to the skin after 36 hours. The patient must avoid any activities that may stress out the area of  degloving injury. The patient's wound  may heal after 3 months.

Tissue reconstitution results from an orderly series of overlapping phases that characterize wound healing. Hemostasis, inflammation, proliferation, and the development of mature scar tissue are all parts of this process.

 The questions and answers from above are in step by step from definition of degloved to the pathophysiology of wound healing. The patient's degloved left leg wound has only mentioned the 4 ×7 inches wound and didnt emphasize much about how deep is the result of the wound. But we can tell that since it is a degloved wound from a fall it may be an open type of wound. The skin is the largest organ of the body and it has many function. Its healing process is unique depending on the severity of the cause. For this patient  degloved in the lower leg. Skin reattachment and skin grafting from donor site is recommended.

sources:

https://www.sciencedirect.com/topics/medicine-and-dentistry/degloving-injury

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126125/