Comprehensive Management Strategies for Degloving Injuries with Associated Jaundice and Septicemia

Author(s): Mohammed Gulam Mustofa, Avishek Bhadra, Sushmoy Saha, Sabbir Ahmed, Ashikur Rahman

Background: Degloving injuries, particularly those complicated by jaundice and septicemia, pose significant clinical challenges due to their complex nature and high risk of morbidity and mortality. This study evaluates demographic, clinical, and management factors affecting outcomes in patients with such injuries in a resource-limited setting in Bangladesh.

Methods: A prospective observational study was conducted at the President Abdul Hamid Medical College Hospital, Kishoreganj, Bangladesh, from January 2023 to December 2024. A total of 40 patients with degloving injuries and associated systemic complications were included. Data were collected on demographics, injury characteristics, management strategies, and outcomes, and analyzed for significant associations with mortality.

Results: The majority of patients were male (80%) and aged 31–45 years (45%), with road traffic accidents being the most common cause (50%). Vascular compromise was observed in 70% of cases, and septicemia severity was moderate in 50% of patients. Management strategies included debridement and primary closure (50%), skin grafting (37.5%), and flap reconstruction (12.5%). The survival rate was 87.5%, with full functional recovery achieved in 50% of survivors. Mortality was significantly associated with age >45 years, SOFA scores >10, severe jaundice, and delayed hospital admission.

Conclusion: This study underscores the importance of early intervention, effective infection control, and comprehensive systemic management in improving outcomes for degloving injuries with systemic complications. Context-specific strategies are critical for addressing these challenges in resource-limited settings.