Complex perineal degloving injury in a 4-year-old girl: A rare pediatric case managed at tertiary hospital
Year: 2025
Type: article
Study design: Case Report
Abstract: Introduction: Perineal degloving injuries are large extensive avulsion of skin, subcutaneous from their underlying fascia resulting from large shear and rotational force commonly due to road traffic in children. Presentation of case: We present a 4 years-old girl was rolled over by a large truck and presented a complex perineal degloving wound with associated pelvic and femur fracture, rectovaginal fistula and urethra disruption. She was managed by a multidisciplinary team including anesthesiologists, pediatric surgeons, orthopedists, urologists, gynecologists, plastic surgeons, nutritionist, and physiotherapists. Although persistent slight limping, functional and cosmetic outcomes improved. Clinical discussion: The management of complex perineal degloving injuries requires proper assessment and coordinated efforts of a multidisciplinary team, during the damage control phase. Initial priorities include copious irrigation, meticulous debridement, and diversion of both stool and urine to minimize contamination and infection risk. Secondary wound exploration and the application of advanced dressing are cointegrated with early nutritional support and physiotherapy, all aimed at optimizing the patient's status for definitive surgical reconstruction. Conclusion: A multidisciplinary team approach is the mainstay in the management of complex perineal degloving wounds. Timely decision-making regarding wound closure must be guided by both the local wound condition and the patient's overall hemodynamic stability. Early involvement of the plastic surgery team is essential as it significantly enhances the potential for optimal functional and aesthetic outcomes.
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4415829589