Deep Skin Avulsion

Deep Skin Avulsion

A 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 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 bones, tendons, nerves, or blood vessels.

What are the causes?

This condition may be caused by an injury, such as:

  • Being crushed.

  • Falling against a jagged surface.

  • An animal bite.

  • A gunshot wound.

  • A severe burn.

  • Being dragged, such as in a bicycle or motorcycle accident.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain.

  • Numbness.

  • Swelling.

  • Bleeding, which may be heavy.

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?

Treatment for this condition depends on how large and deep the wound is and where it is located. Treatment usually starts with:

  • Stopping the bleeding.

  • Washing out the wound with a germ-free (sterile) solution.

After initial treatment, the wound may be closed or left open to heal.

  • 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 your own skin flap.

  • Wounds that are hard to close or that may become infected may be left open. These wounds heal over time.

You may also be treated with medicine, such as:

  • Antibiotic medicine.

  • Pain medicine.

  • Tetanus shot.

Follow these instructions at home:

Medicines

  • If you were prescribed an antibiotic medicine, take or apply it as told by your health care provider. Do not stop taking or using the antibiotic even if your condition improves.

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • If you were prescribed a pain medicine, take it 30 minutes or more before you do any wound care, or as told by your health care provider.

  • Ask your health care provider if the medicine prescribed to you requires you to avoid driving or using machinery.

Wound care

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  • Follow instructions from your health care provider about how to take care of your wound. Make sure you:

    • Wash your hands with soap and water for at least 20 seconds before and after you change your bandage (dressing). If soap and water are not available, use hand sanitizer.

    • Change your dressing as told by your health care provider.

    • Leave sutures, skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.

  • 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 not rub it.

    • Cover the wound with a clean dressing.

  • Keep your dressing clean and dry. Do not take baths, swim, use a hot tub, or do anything that would put your wound under water until your health care provider approves.

  • Check your wound every day for signs of infection. Check for:

    • More redness, swelling, or pain.

    • More fluid or blood.

    • Warmth.

    • Pus or a bad smell.

  • Do not scratch or pick at the wound.

General instructions

  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. These may delay wound healing. If you need help quitting, ask your health care provider.

  • Eat a healthy diet to help your wound heal. This includes eating foods rich in protein, vitamin A, and vitamin C.

  • Keep all follow-up visits. This is important.

Contact a health care provider if:

  • You have pain that does not get better with medicine.

  • You have any of these signs of infection:

    • More redness, swelling, or pain around your wound.

    • More fluid or blood coming from your wound.

    • A fever.

  • You got a tetanus shot and you have swelling, severe pain, redness, or bleeding at the injection site.

  • You are nauseous or you vomit.

  • You notice something coming out of the wound, such as wood or glass.

Get help right away if:

  • You have a red streak going away from your wound.

  • A wound that was closed breaks open.

  • The wound is bleeding, and the bleeding does not stop with gentle pressure.

  • You have trouble breathing.

  • The wound is on your hand or foot and:

    • You cannot properly move a finger or toe.

    • Your fingers or toes look pale or bluish.

Summary

  • A deep skin avulsion is a type of injury that can damage important structures beneath the skin.

  • 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.

  • Follow instructions from your health care provider about how to take care of your wound.

  • Contact your health care provider if you have increased redness, swelling, or pain around your wound, or if your pain is not controlled with medicine.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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