The results of the treatment of hand-Outcomes of the treatment of hand degloving injuries with greater omentum flaps

Degloving injury involves stripping away the soft-tissue integument covering the skeleton of the hand: skin and subcutaneous tissues as well as accompanying nerves and blood vessels. Degloving of the entire hand is one of the injuries associated with the poorest prognosis, even worse than total hand amputation. There is a limited range of possible salvage procedures in such cases and their outcomes are unsatisfactory. One of such methods involves wrapping of the skinned hand with a pedicled or free greater omentum flap retrieved from the abdominal cavity. In this publication we report the outcomes of treatment in 5 patients 8 years on average after total hand degloving and repair using omental flaps. All flaps healed uneventfully, but the whole length of the fingers could not be preserved in any of our patients. Stumps of 3 fingers were separated in one patient, three-digit hands were formed in two others and the thumb alone was isolated in the remaining two patients. Dexterity of injured hands was limited with a mean DASH questionnaire score of 43 points. Quality of life as measured by the SF-36 questionnaire was poor (58 and 53 points in physical and mental domain, respectively). Nevertheless, all patients were satisfied with the achieved outcomes and all returned to work, which corroborated the effectiveness of the used treatment method.