Lower extremity degloving soft tissue injuries: Patterns, treatment, and short-term Outcome in Sudan: A Sub-Saharan African setting

Abstract

Background

Degloving soft tissue injury is among the most devastating trauma types, especially when involving the lower extremities. This study aims to identify degloving soft tissue injury (DSTI) Patterns, Treatment, and Short-term Outcomes.

Methods

This is a prospective, cross-sectional, hospital-based study of patients with DSTIs over six months.

Results

Fifty-six patients with lower extremity DSTIs were included. The mean age of the patients was. 29.2 years.

Males were predominant (71.4 %). The common site for DSTIs is the dorsum of the foot. Fourteen patients with degloving injury to the foot dorsum had open fractures with type 3 A Gustilo classification. Participants with MESS 1 did not have underlying fractures. Patients with higher MESS scores experienced a more severe form of injury. Most of the patients presented late to plastic surgery services. Definitive management offered to the patients includes secondary intention, direct closure, SSG, and loco-regional flap. The loco-regional flaps used were random fascia-cutaneous, sural, saphenous, Lateral gastrocnemius, and medial gastrocnemius. Thirty-nine of the participants had no complications following management. The complications encountered include Surgical site infection, wound dehiscence, and partial graft or flap loss. These complications were managed by local wound care and a local flap. More extended hospital stay was observed in patients with low revised trauma scores.

Conclusion

Lower extremity DSTIs are common injuries in Sudan, and it is management is challenging. DSTIs with underlying fractures are the most common pattern of injury, with the dorsum of the foot being the most commonly affected part. A multidisciplinary approach is essential for management.