Treatment of degloving injury of parts of hand has been one of the difficult problems in hand surgery. Various methods have been applied on the treatment for its unique property. We can classify the methods of treatment into two categories. One is amputation and the other is resurfacing. Due to the fact that most degloving injuries involve mainly the loss of skin and subcutaneous tissue and underlying structures are remained intact, the injured parts can be salvaged when appropriately resurfaced. In Korea, by the Confucian influence, keeping the body intact is an important filial duty. Therefore, there are a great deal of preserve and demands from the traditional perception and from the patient to preserve anything and reattach all that is detached. By so doing, amputation of degloved part is undesirable.
The resurfacing is our first goal to obtain maximum functioanl and cosmetic restoration. We use various flaps and microsurgical techniques for the surgical resurfacing. Recently, with the refinement of microsurgical techniques, reattachment surgery using microvascular techniques was performed by many surgeons.
Authors report an analysis of 20 cases of completely devascularized degloving injuries of hands which were treated at Guro Hospital, Korea University from September of 1983 to August of 1987.
The results are summarized as follows:
1. Fifty percent of the patients were in the age group of 20-30 years and ninty-five percent of the patients were male.
2. Roller accident was the main cause of the injury in 75%.
3. In comparison with other treatment methods, it is represented for the revascularization of the degloved-amputated part using microsurgical technique as the best result aesthetically and functionally. In conclusion, we strongly suggest the reattachment surgery using microsurgical revascularization.
|