Joel Lau ,Xuxin Lim ,Ong Wei Chen ,Yap Yan Lin ,Jane Lim *,Lim Thiam Chye
Introduction: Degloving injuries are most commonly caused by road traffic accidents and industrial accidents. They result from of a large rotational force, which avulses the skin and subcutaneous tissue from the underlying fascia. The majority of such injuries involve the lower extremities. Perineal degloving injury is seldom reported in the literature. Presentation of case: In this case report, we present the case of a 22 year old male pedestrian involved in a motor vehicle accident. He sustained an open perineal degloving injury. Discussion: The management of perineal degloving injuries involves resuscitation and early identification of bony fractures, urogenital or anorectal injuries. Multiple wound irrigation with staged debridement can salvage potentially viable degloved segments. The degloved skin flaps should be secured to the wound bed without tension for the first 5 days. We utilized negative pressure wound therapy as a temporary wound dressing to facilitate wound healing. We opted for a diverting colostomy to minimize infective complications as our patient sustained an extensive perineal injury adjacent to the anus. The patient was nursed on a differential air-loss mattress to minimize pressure necrosis. Delayed wound closure was performed on day 8 of injury after full demarcation has occurred. Conclusion: We managed a specific presentation of an open perineal degloving injury which achieved a favorable outcome. With our approach, we were able to minimize tissue loss, minimize septic complications and reduce patient’s morbidity.
