A Case Report on the Management of the Degloved Foot with the Full Thickness Meshed Skin Graft from the Degloved Skin.

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We have treated a patient, a fiveyear old girl, suffering from right ankle and foot degloving injury with loss of partial calcaneal substance and 1-5th toes, and acute epidural hematoma without clinical sign in a traffic accident. Surgical treatments were attempted for only the degloved foot under general anesthesia.After washing and debridement, coverage was achieved with a full thickness meshed skin graft on the sole from her degloved plantar skin and the split thickness skin graft on the dorsal side of her foot from her buttok for biological dressing and the primary wound repair. Initial attempts at these skin graftings were almost successful except the calcaneal area covered with a cross thigh flap 3 months after the first operation, and stumps of 1, 3, 5th toes. During the grafting skin became soft and stable approximately 6 months after initial treatment, she had to use PTB brace, and resumed full weightbearing in a regular shoe with an arch bar-supported prosthesis, which was made 2 or 3mal par year.Over the ensuring 4 years, the grafted skin on sole remained stable without ulceration but with hyperkeratosis.We feel this technique, the full thickness meshed skin graft from the degloved skin, provides anexpedient and available procedure for a foot degloving injury.
西日本整形・災害外科学会の論文