The force of an avulsion, or degloving, injury is so powerful that the skin is peeled away, damaging blood vessels, muscles, and tendons.
Children suffer such injuries when, for example, their fingers get trapped between the metal rails of amusement park rides. Adults have been injured stepping out of buses, working with drill presses, and holding reins or tow ropes.
The culprit is often a wedding ring.
"When someone falls, they try to grab something and the ring gets stuck, and peels everything off," says Dr. Bardia Amirlak, a plastic surgeon at UT Southwestern Medical Center. "It's a devastating injury."
When an avulsion injury occurs, prompt treatment is required. Such injuries can cut off the blood supply, causing the underlying skin to die. Microsurgery often can restore viability, but it is a delicate procedure requiring expertise in repairing damaged blood vessels, Dr. Amirlak says. Sometimes an artery bypass using the patient's own veins is needed. Because the nerves and vessels are forcibly detached, these injuries often are more difficult to fix than an amputation.
Avulsion injuries can be avoided by removing rings prior to taking part in activities like gardening, handling heavy objects, participating in sports, or doing construction. The thumb, index, and middle fingers are more important for hand function, so wearing rings on these fingers should be avoided at all times.
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