The use of Integra with a sensate fasciocutaneous pedicled flap for the salvage reconstruction of a below knee amputation after pedestrian vs train multi-planar degloving injury.

Abstract

Degloving injuries occur when there is sufficient tangential force to a body surface to disrupt the structures connecting skin and subcutaneous tissues to the superficial fascia. There may also be associated injuries to the underlying soft tissues, bone, nerves and vessels. The injury may be so severe that the limb is non-viable and requires amputation. Our patient sustained a severe lower limb degloving injury after an accident where the leg was caught and dragged along the platform by a train. There was insufficient skin to cover a below knee amputation stump. So, the dermal regeneration template Integra(r) was used in association with a sensate neurovascular fasciocutaneous pedicled flap salvaged from the non-viable lower leg to reconstruct the defect and avoid the need for an above knee amputation.