Surgical management and outcomes of open degloving injuries of the extremities: a retrospective cohort study at a Level II trauma center

BACKGROUND: Open degloving injuries are severe soft-tissue traumas associated with ischemia, infection, and poor functional outcomes. Due to heterogeneous presentations, standardized management protocols remain limited. METHODS: We conducted a retrospective cohort study of 28 consecutive patients with open degloving injuries of the extremities treated at a Level II trauma center between 2020 and 2024. Demographics, injury characteristics, surgical interventions, and outcomes were analyzed using chi-square/Fisher's exact tests and nonparametric methods. RESULTS: Median age was 49 years, and 57.1% were male. Motor vehicle accidents were the most common mechanism (40.7%), with 56.7% involving upper extremities. All but one patient underwent surgical management. Primary debridement was performed in 51.9%, serial debridement in 33.3%, and negative pressure wound therapy in 63.0%. Skin grafting (22.2%) and flap reconstruction (14.8%) were used for definitive closure. Complications occurred in 40.7%, most commonly necrosis (18.5%) and infection (11.1%). Median hospital stay was 7 days. CONCLUSIONS: Early multidisciplinary surgical management is associated with high limb salvage rates and acceptable complication profiles. Prospective multicenter studies are needed to establish standardized treatment algorithms.