Saving a large volume of soft tissue by using an untailored composite graft after total degloving amputation of the hand: a case report

Abstract

Total degloving amputations present surgeons with unique challenges to preserve function and prevent amputation of the digits. Obviously, the replantation of avulsed skin is the best option; however, there are situations in which vascular networks are severely contused, making it difficult to restore the circulation, due to the crushing mechanism of injury. As an alternative, defatted or meshed skin grafts from the avulsed skin have been proposed. However, those options have not been proven to guarantee viable digits. Moreover, the application of thinned skin grafts usually results in cosmetically and functionally unsatisfactory outcomes due to the lack of sufficient tissue volume. We present a case in which we successfully saved a large volume of the amputated stump with minimal digit amputation by performing a composite graft of the untailored (i.e., without defatting or meshing) avulsed skin on a totally degloved hand.