Classification of traumatic integumentary tissue degloving

Abstract

Introduction Detachment or sharp gross prolonged displacement of the skin, subcutaneous fatty tissue from the underlying fascia over more than 1 % of the body surface with disorders of blood supply to these and sometimes underlying tissues results from high-energy mechanical action of various moving objects and force applied at an angle. Purpose to develop a classification of integumentary tissue detachments based on the variety of clinical types, severity, extent, combination of injuries with a possible quantitative assessment of their severity and extent. Methods Analysis of the literature and our own experience of treating 40 patients with detachments of integumentary tissues enabled to identify criteria for classifying patients into groups. Results A classification and rating scales were developed that reflect the area, depth of tissue damage, localization, general condition of the patient and the stage of the pathological process. Discussion The analysis of the literature on this topic showed that, to date, none of the proposed classifications is optimal. There is no clear definition of the area of compromised integumentary tissues relative to the entire surface of the human body. The issue of pathological process staging has not been reflected; damage and crushing of bones, muscle tissue, neurovascular formations have not been reflected; there is no clearly formulated algorithm for treating a patient depending on the stage and severity of tissue damage. Conclusion Application of the classification of integumentary tissue detachments which has been proposed enables to more objectively assess the nature of local tissue damage, taking into account the general condition of the patient.