Healing a deep skin and tissue injury after a crash
A reconstructive surgeon and a wound nurse explain healing in stages
In a major crash, skin and deeper tissue can be torn away from the structures underneath. Doctors may call this a degloving injury. A wound that seems small at first can hide damaged tissue under the skin. Treatment may include cleaning and removing tissue that can’t survive. It may also mean a skin graft or a tissue flap. You may need more than one procedure. [1]
A reconstructive surgeon plans how to cover the wound. A wound nurse helps you protect it each day. [1]
Find out what tissue was repaired
Ask if any muscle, tendon, nerve or bone was exposed or hurt. Find out what covers the wound. It could be your original skin, a graft or a flap with its own blood supply. Ask which areas are still being watched to see if the tissue survives. A donor site, where skin or tissue was taken, needs its own care instructions. Keep a diagram or photo your team has approved so you can explain the repair accurately later. [1, 2]
Guard the repair and keep your movement
Have the nurse show you the dressing routine and explain what drainage to expect. Ask whether pressure, stretching or weight on the area could harm the repair. Find out when movement and therapy should start. A wound can close and still leave stiffness or weakness behind. Check that your rehab plan includes the nearby joint and any injured tendon or nerve. [1, 2]
Changes that need a call
Contact your surgical team for redness that spreads, more pain, fever, drainage that smells bad or a wound that opens. Get quick advice if a flap or graft turns pale, dark or cold. If you feel very unwell, get emergency care. Don’t hold off until a routine visit to report a change in how the tissue looks. [2]
Questions for your reconstructive team
- Which tissues were hurt, and which were used to cover the wound?
- What are my dressing and movement rules at home?
- Who checks the wound, and when does therapy start?
Try your first dressing change with a nurse watching
Do your first dressing change while the wound nurse watches. After that, keep the written supply list and contact number close by. [2]
Sources and further reading
- 1Imperial College Healthcare open fracture management guidance
- 2Frimley Health care of your wound following plastic surgery
General education from reconstructive surgery and wound nursing. Every wound is different. Stick to the dressing, movement and follow up plan made for your repair.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
