J Reconstr Microsurg 2003; 19(4): 217-220
DOI: 10.1055/s-2003-40576
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Replantation of Total Degloving of the Hand: Case Report

B. P. Thomas, E. Katsarma, T.-M. Tsai
  • Christine M. Kleinert Institute of Hand and Microsurgery, Louisville, KY
Further Information

Publication History

Publication Date:
14 July 2003 (online)

ABSTRACT

This article reports a patient who had a total degloving of the hand, caused by a roller injury, up to the distal forearm level. The authors replanted the degloved skin using arteriovenous anastomosis of the radial artery at the wrist to the cephalic vein in the degloved skin in an end-to-side manner. To enhance the survival of the replanted skin, it was deepithelialized and buried in an abdominal pocket created specifically for this purpose. The replanted skin survived, except at the terminal portions of the fingers. The patient had reasonable function and cosmesis after the wound healed. The procedure may be used for the treatment of this rare injury to salvage a cosmetically acceptable and functional hand.

REFERENCES

  • 1 McGregor I A. Degloving injuries.  Hand . 1970;  2 13-133
  • 2 McGregor I. Flap reconstruction in hand surgery: the evolution of presently used methods.  J Hand Surg . 1979;  4A 1-10
  • 3 Kleinman W B, Dustman J A. Preservation of function following complete degloving injuries to the hand: use of simultaneous groin flap, random abdominal flap, and partial-thickness skin graft.  J Hand Surg . 1981;  6A 82-29
  • 4 Watson A, McGregor J C. The simultaneous use of a groin flap and a tensor fasciae latae myocutaneous flap to provide tissue cover for a completely degloved hand.  Br J Plast Surg . 1981;  34 349-352
  • 5 Pshenisnov K, Minachenko V, Sidorov V, Hitrov A. The use of island and free flaps in crush avulsion and degloving hand injuries.  J Hand Surg . 1994;  19A 1032-1037
  • 6 Adani R, Busa R, Castagnetti C. et al . Replantation of degloved skin of the hand.  Plast Reconstr Surg . 1998;  101 1544-1551
  • 7 Al-Shammari S, Gupta A. Revascularization of the digits and palm.  Hand Clin . 2001;  17 411-417
  • 8 Hsu W M, Wei F C, Lin C H. et al . The salvage of a degloved hand skin flap by arteriovenous shunting.  Plast Reconstr Surg . 1996;  98 146-150
  • 9 Takeuchi M, Sasaki K, Nozaki M. Treatment of a degloved hand injury by arteriovenous anastomosis: a case report.  Ann Plast Surg . 1997;  39 174-177
  • 10 Van Beek A, Kutz J E, Zook E G. Importance of the ribbon sign, indicating unsuitability of the vessel in replanting a finger.  Plast Reconstr Surg . 1978;  61 32-35
    >