What is Deep Skin Avulsion
Deep skin avulsion is a type of open wound. It often results from a severe injury (trauma) that tears away all layers of the skin or an entire body part.
The areas of the body that are most often affected by a deep skin avulsion include the face, lips, ears, nose, and fingers.
A deep skin avulsion may make structures below the skin become visible. You may be able to see muscle, bone, nerves, and blood vessels. A deep skin avulsion can also damage important structures beneath the skin. These include tendons, ligaments, nerves, or blood vessels.
What are the causes?
Injuries that often cause a deep skin avulsion include:
- Being crushed.
- Falling against a jagged surface.
- Animal bites.
- Gunshot wounds.
- Severe burns.
- Injuries that involve being dragged, such as bicycle or motorcycle accidents.
What are the signs or symptoms?
Symptoms of a deep skin avulsion include:
- Pain.
- Numbness.
- Swelling.
- A misshapen body part.
- Bleeding, which may be heavy.
- Fluid leaking from the wound.
How is this diagnosed?
This condition may be diagnosed with a medical history and physical exam. You may also have X-rays done.
How is this treated?
The treatment that is chosen for a deep skin avulsion depends on how large and deep the wound is and where it is located. Treatment for all types of avulsions usually starts with:
- Controlling the bleeding.
- Washing out the wound with a germ-free (sterile) salt-water solution.
- Removing dead tissue from the wound.
A wound may be closed or left open to heal. This depends on the size and location of the wound and whether it is likely to become infected. Wounds are usually covered or closed if they expose blood vessels, nerves, bone, or cartilage.
- Wounds that are small and clean may be closed with stitches (sutures).
- Wounds that cannot be closed with sutures may be covered with a piece of skin (graft) or a skin flap. Skin may be taken from on or near the wound, from another part of the body, or from a donor.
- Wounds may be left open if they are hard to close or they may become infected. These wounds heal over time from the bottom up.
You may also receive medicine. This may include:
- Antibiotics.
- A tetanus shot.
- Rabies vaccine.
Follow these instructions at home:
Medicines
- Take or apply over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed an antibiotic, take or apply it as told by your health care provider.Do notstop taking the antibiotic even if your condition improves.
- You may get anti-itch medicine while your wound is healing. Use it only as told by your health care provider.
Wound care
- There
are many ways to close and cover a wound. For example, a wound can be
covered with sutures, skin glue, or adhesive strips. Follow instructions
from your health care provider about:
- How to take care of your wound.
- When and how you should change your bandage (dressing).
- When you should remove your dressing.
- Removing whatever was used to close your wound.
- Keep the dressing dry as told by your health care provider. Do nottake baths, swim, use a hot tub, or do anything that would put your wound underwater until your health care provider approves.
- Clean
the wound each day or as told by your health care provider.
- Wash the wound with mild soap and water.
- Rinse the wound with water to remove all soap.
- Pat the wound dry with a clean towel. Do notrub it.
- Do notscratch or pick at the wound.
- Check
your wound every day for signs of infection. Watch for:
- Redness, swelling, or pain.
- Fluid, blood, or pus.
General instructions
- Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You received a tetanus shot and you have swelling, severe pain, redness, or bleeding at the injection site.
- You have a fever.
- Your pain is not controlled with medicine.
- You have increased redness, swelling, or pain at the site of your wound.
- You have fluid, blood, or pus coming from your wound.
- You notice a bad smell coming from your wound or your dressing.
- A wound that was closed breaks open.
- You notice something coming out of the wound, such as wood or glass.
- You notice a change in the color of your skin near your wound.
- You develop a new rash.
- You need to change the dressing frequently due to fluid, blood, or pus draining from the wound.
Get help right away if:
- Your pain suddenly increases and is severe.
- You develop severe swelling around the wound.
- You develop numbness around the wound.
- You have nausea and vomiting that does not go away after 24 hours.
- You feel light-headed, weak, or faint.
- You develop chest pain.
- You have trouble breathing.
- Your wound is on your hand or foot and you cannot properly move a finger or toe.
- The wound is on your hand or foot and you notice that your fingers or toes look pale or bluish.
- You have a red streak going away from your wound.
