During the assessment of a patient who was involved in an industrial accident, you note a wound on the forearm where the skin and subcutaneous tissue have been completely peeled away, exposing the underlying muscles and tendons. How would this type of injury be classified?
Incisional wound
Avulsion
Degloving injury
Abrasion
This presentation is characteristic of a degloving injury, in which a large area of skin and subcutaneous tissue is sheared off the underlying fascia, muscle, or bone. Such wounds are commonly produced by high-energy industrial or roadway mechanisms. In contrast, an avulsion is any tearing away of tissue and may be smaller or lack the circumferential "peeling" seen in degloving. Incisional wounds are linear, clean cuts made by sharp objects, and abrasions involve only superficial epidermal layers without deep structure exposure.
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