Degloving injuries are common in trauma and represent a spectrum of complex wounds, the management of which may be highly challenging especially in the paediatric population. In severe injuries leading to wounds reaching tendon and bone, vascularity is compromised precluding traditional wound management, and sometimes necessitating amputation. This report highlights the use of a dermal regeneration template combined with vacuum-assisted closure (VAC) in the treatment of complex traumatic degloving wounds. Here, we present a case of a five-year-old boy who sustained a high-energy shear injury to his lower extremity that resulted in an extensive degloving wound involving the distal third of his leg and the dorsum of his foot. After debridement, the patient underwent VAC combined with a dermal skin substitute placement, followed by split-thickness skin grafting. The extremity healed with no complications and without the need for amputation or flap reconstruction, achieving satisfactory recovery of range of motion and favourable cosmetic results.
Keywords: degloving injury; dermal regeneration template; integra; lower extremity reconstruction; negative pressure wound therapy; vacuum-assisted closure.