A sudden shearing force can detach the skin and subcutaneous tissue from the underlying fascia. The blood vessels supplying the skin are torn, and the overlying tissue will eventually become ischemic. The injury may be overlooked unless the clinician has a high index of suspicion.


Exposures that can result in a closed degloving injury:

(1) being run over by the tires of a motor vehicle

(2) rotating rollers

(3) other shearing force


Clinical findings:

(1) changes to the skin surface (friction burn, abrasions, ecchymosis)

(2) excessive mobility of skin and subcutaneous tissue

(3) hemorrhage between the fascia and subcutaneous fat with hematoma formation (can be aspirated with a syringe)

(4) dusky discoloration of affected area after several hours

(5) necrotic subcutaneous fat may become depressed relative to the surrounding viable tissue


The wound can be managed like a full thickness burn. The epidermis from debrided skin can be harvested for later placement.


To read more or access our algorithms and calculators, please log in or register.