چکیده (انگلیسی):

Objective: To summarize the characteristics of total hand degloving injury and
investigate the curative effect of microsurgery.
Methods: A total of 46 patients with total hand degloving injury were enrolled in this study.
The injury classification and treatment methods were as follows: Type I (11 cases), treated
by replantation of the gloved skin; Type II (6 cases), treated by reconstruction using thumb
wrap-around flap and second toe; Type III (4 cases), treated by reconstruction using bilateral
second toe with dorsal foot flap; Type IV (9 cases), treated by replantation in situ or reconstruction;
Type V (16 cases), treated by replantation or abdominal flap reconstruction.
Results: Of the patients who received Type I treatment, five completely survived, whereas
eight had finger necrosis. In Type II, both the reconstructed fingers and hand flaps survived.
For four patients who received Type III treatment, eight reconstructed fingers survived. In Type
IV, two patients with reconstructed fingers survived, whereas the six with replantation in situ
had necrosis of the partial palmar or hand dorsum skin. In Type V, nine patients with reconstructed
fingers survived, and five cases with abdominal skin flap reconstruction and one case
with anterolateral femoral flap survived. The restoration of hand appearance and function was
the best in patients who received replantation. For reconstruction cases, however, the hand
function was recovered to the basic self-care level. In cases with abdominal flap reconstruction,
the hand function showed poor recovery.
Conclusion: Total hand degloving injury can be classified into different types according to the
injury degree. The appropriate microsurgical treatment based on these types can produce better
curative effect.