JPRAS open · 2026
The use of avulsed soft tissue for immediate full-thickness skin grafting in traumatic extremity injuries: A multi-institutional 10-year retrospective review of outcomes with technical considerations.
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Clegg Devin J, Mueller Stephanie M, Du Amy, Yu LaYow C, Eberlin Kyle R, Carty Matthew J, Talbot Simon G, Orgill Dennis P
Аннотация
BACKGROUND: Avulsion or degloving injuries of the extremities are often caused by high-energy trauma and can be associated with high morbidity. Multiple techniques have been proposed for management, including immediate full-thickness skin grafting (IFTSG). Despite previous publication of our experience with this technique in 1999, awareness and implementation by surgeons remains poor. Outcomes of patients who underwent IFTSG from traumatically avulsed extremity soft tissues over a 10-year period were reviewed, with technical considerations included.
METHODS: A retrospective cohort study of patients with degloving/avulsion-type traumatic injuries of the extremities who underwent IFTSG from January 2015 to December 2025 at two academic institutions was performed. Patients without follow-up to complete healing or final outcome were excluded. Descriptive statistical analysis was performed, with case photos and surgical technique description included.
RESULTS: Fourteen patients were included. Upper extremity injuries occurred in 86% of patients. Associated fractures occurred in 29% of patients, and 71% had initial exposure of critical underlying structures. Mean IFTSG size was 140 cm2. Mean percentage of initial IFTSG take was 88%. Complete healing was achieved in 100% of patients, with a mean time of 87 days. Two patients required additional skin grafting. No patients underwent flap procedures, placement of skin substitutes, or proximal amputations.
CONCLUSIONS: In appropriate patients, IFTSG of avulsed soft tissue in traumatic extremity wounds can reliably achieve complete healing with low complication risk and no additional donor site morbidity. Comparative studies are needed, but these promising findings should increase awareness of this technique for surgeons treating similar wounds.
METHODS: A retrospective cohort study of patients with degloving/avulsion-type traumatic injuries of the extremities who underwent IFTSG from January 2015 to December 2025 at two academic institutions was performed. Patients without follow-up to complete healing or final outcome were excluded. Descriptive statistical analysis was performed, with case photos and surgical technique description included.
RESULTS: Fourteen patients were included. Upper extremity injuries occurred in 86% of patients. Associated fractures occurred in 29% of patients, and 71% had initial exposure of critical underlying structures. Mean IFTSG size was 140 cm2. Mean percentage of initial IFTSG take was 88%. Complete healing was achieved in 100% of patients, with a mean time of 87 days. Two patients required additional skin grafting. No patients underwent flap procedures, placement of skin substitutes, or proximal amputations.
CONCLUSIONS: In appropriate patients, IFTSG of avulsed soft tissue in traumatic extremity wounds can reliably achieve complete healing with low complication risk and no additional donor site morbidity. Comparative studies are needed, but these promising findings should increase awareness of this technique for surgeons treating similar wounds.