head JofIMAB
Journal of IMAB
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue3
Subject Area: Medicine
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DOI: 10.5272/jimab.2024303.5700
Published online: 26 August 2024

Case report
J of IMAB. 2024 Jul-Sep;30(3):5700-5702
DISTANT SOFT TISSUE FLAPS IN A DEGLOVING SKIN INJURY
Mancho Kovachev1, 2ORCID logoCorresponding Autoremail, Hristo Gigov1, 2ORCID logo, Vihar Kovachev1, 2ORCID logo, Denis Dimitrov1, 2ORCID logo,
1) Department of Orthopedics and Traumatology, Medical University of Pleven, Bulgaria.
2) Clinic of Orthopedics and Traumatology, University Hospital "Georgi Stranski" - Pleven, Bulgaria.

ABSTRACT:
Avulsion skin injuries of the glove removal type are one of the most challenging and difficult problems in reconstructive hand surgery. Immediate or early coverage of the hand is of utmost importance. Several options are proposed for early covering the preserved structures (tendons, bones and nerves) early, mainly skin grafting on the preserved viable structures.
Case description: We present a case of a patient with 4th and 5th finger crushing and avulsion skin injury of thumb and index finger and lost distal phalanges. The 4th and 5th fingers had been amputated due to gangrene. Two anterior abdominal wall flaps were applied: a thoraco-umbilical flap and a horizontal Filatov stem" flap. On the 25th day, the flaps were separated from the fingers and following commissuroplasty 10 months later.
Result: Fusion between the donor flap and the recipient structures was obtained without clinical evidence of infection, ulceration and flap necrosis.
Conclusions: The usage of remote skin flaps is a safe and simple method to restore hand function when microsurgery cannot be applied.

Keywords: subcutaneous defects, glove injury, abdominoplasty, thoraco-umbilical flap, thoracoabdominal flap, Filatov's pedicle flap, commissuroplasty,

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Please cite this article as: Kovachev M, Gigov H, Kovachev V, Dimitrov D. Distant soft tissue flaps in a degloving skin injury. J of IMAB. 2024 Jul-Sep;30(3):5700-5702. [Crossref - 10.5272/jimab.2024303.5700]

Corresponding AutorCorrespondence to: Mancho Kovachev, Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Pleven, Clinic of Orthopaedics and Traumatology of G. Stranski University Hospital – Pleven; 89, Rousse Blvd., Pleven, Bulgaria; E-mail: mani.rivera@abv.bg

REFERENCES:
1. Yamada N, Ui K, Uchinuma E. The use of a thin abdominal flap in degloving finger injuries. Br J Plast Surg. 2001 Jul;54(5):434-8. [PubMed]
2.Naalla R, De M, Dawar R, Chauhan S, Singhal M. Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery. J Hand Microsurg. 2018 Apr;10(1):29-36. [PubMed]
3. Yu YD, Zhang YZ, Bi WD, Wu T. Functional sensory function recovery of random-pattern abdominal skin flap in the repair of fingertip skin defects. Exp Ther Med. 2013 Mar;5(3):830-834. [PubMed]
4. Sharma A, Kumar A, Singh K, Beniwal M, Yadav U. Reconstruction of forearm and elbow defects by pedicled periumbilical perforator based Thoracoumbilical flap: an alternative to free flaps. J Orthop Trauma Surg Rel Res. 2023 Mar 31;18(3):1-6. [Internet]
5. Krishnamoorthy R, Karthikeyan G. Degloving Injuries of the hand. Indian J Plast Surg. 2011 May;44(2):227-36. [PubMed]
6. Ramadevi V, Kumar KS. Pedicle Thoracoumbilical flap for soft tissue coverage defects around elbow region. IOSR-JDMS. 2019 Feb;18(2 Ser.17):23-27. [Internet]
7. Arnez ZM, Khan U, Tyler MP. Classification of soft tissue degloving in limb trauma. J Plast Reconstr Aesthet Surg. 2010 Nov;63(11):1865-9. [PubMed]
8. Mir MA, Khurram F, Kumar D. Pedicled thoracoumbilical flap coverage for wounds around elbow. Turk J Plast Surg. 2020 Jan-Mar;28(1):14-18.  [Internet]
9. Adani R, Busa R, Castagnetti C, Castagnetti L, Caroli A. Reimplantation of degloved skin of the hand. Plast Reconstr Surg. 1998 May;101(6):1544-51. [PubMed]
10.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 Am. 1994 Nov;19(6):1032-7. [PubNed]
11. McGeorge DD, Stilwell JH. The management of the complete ring avulsion injury. J Hand Surg Br. 1991 Nov;16(4):413-4. [PubMed]
12. Kaufman R, Nguyen J, Williams B, Lopez R, Boc SF. Treatment of Traumatic Degloving Injury of the Foot Using a Biologic Dressing in a Pediatric Patient. Wounds. 2019 Dec;31(12):E77-E81. [PubMed]

Received: 15 May 2024
Published online: 26 August 2024

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