Degloving soft tissue injuries of upper limbs and their management in Khartoum - Sudan: a cross-sectional study.

Abstract

Background: Degloving soft-tissue injuries are underreported in Sudan and are potentially devastating. They require early recognition and diagnosis with early and systemic management to reduce the complications that may arise, and to minimize delay for proper intervention by a multidisciplinary team that is usually needed to ensure the effective rehabilitation of these patients and a better outcome.

Objective: To assess the degloving soft tissue injuries of the upper limb and their management in Khartoum.

Material and methods: A cross-sectional hospital-based study is multicentric (Khartoum North Teaching Hospital, Association Specialized Hospital, East Nile Hospital) in Khartoum - Sudan. A study was conducted on 82 patients with degloving soft tissue injuries of the upper limbs during the period from 2021 to 2022. Patients with different age groups were included whereas patients with close degloving injuries and degloving injuries of fingers were excluded.

Results: Eighty-two patients were studied. The male-to-female ratio was 4.8:1, with a mean age of 31.5. The common (59.8%) injury site was the dominant upper limb, with 58.5% distal UL injuries. The main etiology of injury was road traffic accidents (52.4%), followed by occupational injuries (20.7%). 51.2% of the injury was a noncircumferential single-plane degloving soft tissue injury. Degloving soft tissue injuries of the upper limbs are associated with deep structure injuries in 61% of patients (bone fracture in 43.9%). Serial debridement before reconstruction as a staged procedure was done in 61% of patients. The most common reconstruction method performed was skin grafts (57.3%), followed by flaps (32.9%). Half (52.4%) of the patients developed complications postoperatively, and the most frequent complication was wound infection (23.1%).

Conclusion: Upper limb degloving soft tissue injuries are complex life-threatening injuries that, if present late or poorly managed, lead to devastating complications ranging from local infection to major disabilities, amputation, and death.