EUROPEAN JOURNAL OF PLASTIC SURGERY, vol.33, no.1, pp.41-44, 2010 (ESCI)
Closed degloving injury is a significant soft tissue injury that is associated with a pelvic trauma in which the subcutaneous tissue is torn away from the underlying fascia, creating a cavity filled with hematoma and liquefied fat. It commonly occurs over the great trochanter but may also occur in the flank and lumbodorsal region. Direct crush injury to the pelvis or a high-speed motor crash are the most common mechanisms of injury. Closed degloving injuries are uncommon but significant injuries, and the diagnosis may be missed at the time of acute trauma. They may give rise to significant morbidity if they are not treated correctly. In this report, we describe a missed closed degloving injury of the sacro-gluteal region of a 51-year-old female patient. Although the necrotic plaques and the palpable fluid collection under the plaques were clinically considered as a lesion caused by traumatic event initially, a small incision to the necrotic plaque on the gluteal region showed abundant serosanginous fluid of 5 1 flow, and postaspiration computed tomography images demonstrated a large air-filled cavity extending from the L3 to S2 vertebrae. This appearance suggested that it was a missed closed degloving injury.