Degloving is an injury that happens when the top layers of the skin and tissue rip from the muscle, connective tissue, or bone. Degloving injuries are often life threatening.

Degloving, also called avulsion, is a serious injury that occurs when skin and tissue rip away from the underlying muscle, connective tissue, or bone.

Degloving can affect any body part, but it’s more common in the legs. There are two main types of degloving: open degloving and closed degloving.

Degloving injuries are often life threatening. This is because they involve large amounts of blood loss and tissue death.

Read on to learn about the types of degloving, treatment options, and possible complications.

Open degloving is when the skin and tissue rips away from an injury and exposes muscle, bone, or connective tissue

In some cases, the skin might still be partially attached as a flap near the wound.

Open degloving injuries are usually caused by:

  • traffic accidents
  • falls from heights
  • sports injuries
  • animal bites
  • construction injuries

The most common areas for open degloving injuries are the legs. However, they can affect other areas of the body, such as the:

  • hand
  • wrist
  • head
  • face

Open degloving injuries are usually serious. They require emergency care to reduce blood loss and prevent infection.

Closed degloving injuries aren’t always visible. This makes them harder for doctors to diagnose.

In some cases, they can cause a bruise, but this is usually the only visible symptom.

Many closed degloving injuries involve a force that separates the top layer of skin and tissue from deeper tissues, leaving a space under the skin. These spaces are known as Morel-Lavallée lesions. The lesions can fill with lymph fluid, blood, and fat.

A 2017 review estimated that up to one-third of people with Morel-Lavallée lesions may have a delayed diagnosis.

Despite their different appearance, closed degloving injuries are caused by the same types of accidents that lead to open degloving injuries.

Morel-Lavallée injuries are most common at the top of the hip bone in an area called the greater trochanter.

Other common areas include the:

  • torso
  • buttocks
  • lower spine
  • shoulder blades
  • knees

Most doctors diagnose closed degloving injuries using an MRI scan, which can detect Morel-Lavallée lesions.

Treatment for degloving injuries depends on the type, severity, and location of the injury. They’re also often accompanied by other serious injuries, such as broken bones, and these will also require emergency treatment.

The availability of advanced trauma treatment is also a factor. Not all emergency centers may have the expertise for complex skin repair.

Open degloving injuries

Treating open degloving injuries depends on both the extent of the injury and hospital resources. Not all emergency rooms are equipped to handle complex skin repair. You may need to be transferred to a nearby trauma center for more advanced treatment.

Depending on the amount of skin left and the type of injury, treatment options include:

  • reattaching the skin
  • skin grafts using skin from other parts of the body
  • reattachment of a finger or toe
  • amputation

All of these options usually require multiple surgeries. You may need to stay in the hospital for days or weeks, depending on the injury. You may also need to follow up with physical therapy to regain use of the injured body part.

In some cases, a small degloving injury will only need a thorough cleaning and some bandaging to help it heal.

Closed degloving

Treating closed degloving injuries also depends on the extent of the injury. For more minor cases, you may just need a combination of compression bandages, physical therapy, and rest.

For more severe cases, treatment options include:

  • draining any built-up fluid from the lesion
  • removing dead tissue
  • sclerotherapy, which involves injecting blood vessels with medication to make them shrink

Degloving injuries are very serious on their own, but they also carry a big risk of infection since they’re often very deep wounds.

To minimize this risk, make sure you seek emergency medical treatment so the wound is thoroughly cleaned.

As you recover, make sure to tell your doctor if you have any of the following symptoms:

  • red or discolored edges surrounding the wound
  • swelling of the wound
  • oozing around the wound, especially if it’s yellow or smells bad
  • fever
  • body aches

Without treatment, closed degloving injuries can also lead to severe tissue death.

Degloving injuries are serious and sometimes fatal. Open degloving happens when an injury causes the top layers of skin and tissue to rip away from muscle, tissue, or bone.

With closed degloving injuries, the top layer of skin remains in place, so they are harder to identify. An imaging test such as an MRI can help diagnose them.

Early treatment is key to prevent infections. Treatment for a degloving injury will depend on the severity, but may include skin reattachment, skin grafts, reattachment of a limb such as a finger, or amputation.

Seek immediate medical help if open degloving occurs or if there is a serious injury that may have caused closed degloving.