Hand and wrist complete degloving: A case report and litterature review.

IF 0.4 4区 医学 Q4 SURGERY Annales De Chirurgie Plastique Esthetique Pub Date : 2024-10-23 DOI:10.1016/j.anplas.2024.09.005
L Chouquet, Y Berkane, G Paleu, S Gandolfi, O Camuzard, E Lupon
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Abstract

Introduction: Complete hand degloving injuries are traumatic avulsion injuries causing the skin to pull away from the underlying tissues and are most often caused by industrial machinery. We present the case of a degloving trauma of the whole fingers, hand, and wrist resulting in a "watch hand" by analogy with the "ring finger" and discuss alternatives and recommendations from the rare cases described of similar traumas.

Case presentation: A 33-year-old manual worker, a non-smoker with no significant medical or surgical comorbidities, was admitted for a complete skin avulsion of the left hand and wrist following a work-related accident with a trommel-type industrial roller. Our approach covered the five fingers and the dorsal aspect of the hand and wrist with an artificial dermal matrix, while the palmar side of the hand and wrist was covered with a pedicled groin flap in emergency. At 15months, the patient's sensitivity was classified as S1 on the sensory evaluation scale, joint mobility was less than 30°, and the residual hand retained what we might call "basic" functions, i.e., a counterweight when carrying loads and the ability to pick up and hold a light object in the thumb-index grasp.

Conclusion: Complete soft tissue hand defects are exceptional and require urgent treatment. If re-implantation is not possible, combining a dermal matrix with a pedicled flap is a simple salvage solution. The risks of vascular, infectious, and stiffening complications in these traumas are high and must be prevented. Patients must be warned of the severity of the trauma, the need for secondary surgeries to restore a policy-digital grip, and the poor functional results expected.

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手和手腕完全脱位:病例报告与文献综述
简介手部完全脱皮伤是一种外伤性撕脱伤,导致皮肤与下层组织分离,多由工业机械造成。我们介绍了一例整个手指、手部和腕部的脱皮创伤病例,通过与 "无名指 "的类比,该病例导致了 "手表手",并从类似创伤的罕见病例中讨论了替代方案和建议:一名 33 岁的体力劳动者,不吸烟,没有明显的内外科并发症,在一次使用滚筒式工业滚筒的工伤事故中左手和手腕皮肤完全撕脱而入院。我们的方法是用人工真皮基质覆盖五指以及手和手腕的背侧,而手和手腕的掌侧则在紧急情况下用带蒂腹股沟皮瓣覆盖。15个月后,患者的敏感度在感觉评估量表中被列为S1级,关节活动度小于30°,残留的手保留了我们可以称之为 "基本 "的功能,即负重时的配重,以及用拇指和食指抓起并握住轻物的能力:结论:手部软组织完全缺损是一种特殊情况,需要紧急治疗。如果无法进行再植,将真皮基质与带蒂皮瓣相结合是一种简单的挽救方法。在这些创伤中,血管、感染和硬化并发症的风险很高,必须加以预防。必须提醒患者注意创伤的严重性、为恢复政策数字握力而进行二次手术的必要性以及预期的不良功能效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.00
自引率
0.00%
发文量
86
审稿时长
44 days
期刊介绍: Qu''elle soit réparatrice après un traumatisme, pratiquée à la suite d''une malformation ou motivée par la gêne psychologique dans la vie du patient, la chirurgie plastique et esthétique touche toutes les parties du corps humain et concerne une large communauté de chirurgiens spécialisés. Organe de la Société française de chirurgie plastique reconstructrice et esthétique, la revue publie 6 fois par an des éditoriaux, des mémoires originaux, des notes techniques, des faits cliniques, des actualités chirurgicales, des revues générales, des notes brèves, des lettres à la rédaction. Sont également présentés des analyses d''articles et d''ouvrages, des comptes rendus de colloques, des informations professionnelles et un agenda des manifestations de la spécialité.
期刊最新文献
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