Complex lower limb wounds from rare post-traumatic skin degloving during the COVID19 pandemic in central-western Brazil: a case report

um relato de caso

Abstract

Background:  Reconstruction of lower limbs (LL) resulting from trauma is one of the greatest challenges in Plastic Surgery1. With the return of activities after the Covid-19 pandemic, it was possible to observe an increase in hospitalization rates due to traffic accidents, also increasing hospitalizations for complex LL wounds5. This study aims to present a rare case of complex LL wounds due to traumatic skin degloving. Case Report: A 29-year-old male patient, with no previous comorbidities, was admitted to the Plastic Surgery Service of the Regional Hospital of Asa Norte for complex injuries in the lower limbs after a motorbike x bus car accident. He underwent optimized clinical treatment and ten surgical and curative debridements, including the vacuum modality. The patient improved with the appearance of the lesion and then underwent two more surgeries for skin autograft. He was discharged from hospital after one hundred and nine days of hospitalization and was referred for interdisciplinary outpatient follow-up. Discussion: Traumatic LL injuries occur mainly in young male adults, victims of accidents involving motorcycles6, between the second and third decades of life. The management of complex wounds requires clinical and/or surgical treatment3. With regard to surgical treatment, there are several techniques, and one should opt, whenever possible, for less complex procedures, such as skin grafts15. Conclusion: This study brought a rare case that occurred in the Brazilian Midwest without a previous similar description, presenting extreme difficulties in clinical and surgical management that were resolved by improving relevant therapeutic techniques.