Background: This study aimed to assess the efficacy and safety of a single-stage procedure using single-layer Pelnac and defatted avulsed skin for the management of degloving injuries of the forearm and hand.
Methods: This is a prospective study conducted from March 2013 to May 2017. A total of 15 consecutive patients with degloving injuries of the forearm and hand were treated with a single-stage procedure using single-layer Pelnac and defatted avulsed skin as a split-thickness skin graft. Post-operatively, scheduled follow-up was conducted.
Results: The overall 'take' rate of the Pelnac dermal template and the skin graft was 85-100%. No infections, haematoma or seroma were observed during hospitalization and after discharge. At the final follow-up, patients' subjective satisfaction with the aesthetic appearance of the grafted areas was, on average, 71.0 (SD 8.0, range 55-92). The Vancouver Scar Scale value was 2.1 (SD 1.8, range 1.0-5.5), representing a good result. The response of 'normal or near normal' to the sensory recovery was obtained for 13 patients and 'slight loss' for two patients. The average Disabilities of the Arm, Shoulder and Hand score was 21.2 (SD 13.5, range 0-53), and most patients (14/15) regained the ability to perform the daily activities without pain or restriction by tissue adhesion.
Conclusion: This single-stage procedure represents an effective technique for the management of degloving injuries of the forearm and hand and should be considered an alternative to other reconstructive procedures.
Keywords: bone/tendon exposure; degloving injury; dermal regeneration template; vacuum sealing drainage.
© 2019 Royal Australasian College of Surgeons.