Road Traffic Accident (degloving injury)

27 Sept

Background

This young person was involved in a serious road traffic accident at the end of 2020, sustaining severe skin loss and requiring skin grafting. At the time, there was even concern about the possible loss of her leg due to the severity of the injury. My first appointment with her was three years post-injury. She had received a lot of physiotherapy but no in-person, hands-on scar physiotherapy until we met.

Presenting Problem

She experienced extreme pain, profound tightness of the scarring and swelling of the foot and ankle.

Clinical Assessment

The scarring was non-pliable — there was no “give,” and touching it felt like pressing against a brick wall. Oedema (swelling) was present, and ankle range of movement was severely limited.

Treatment Provided

The main treatment provided was LPG (mechanical massage for tissue mobilisation), delivered in multiple weekly sessions.

Outcome

Her pain improved, but the most notable change was a significant increase in scar pliability (movement and flexibility). This reduced the sensation of tightness and helped decrease swelling in the foot and ankle

Tips

Think Beyond the Scar

In severe injuries, scar management is just one aspect of recovery. This patient also needed physiotherapy and occupational therapy to address fractures and broader rehabilitation needs. Physical, functional and psychosocial input are equally important to long-term outcomes.

Progress Takes Time but It’s Possible

This patient’s determination, the support of her family and friends, combined with the care of many professionals, including on discharge the support of The Katie Piper Foundation, has enabled her to build a busy, full and successful life. It can be hard to see the light at the end of the tunnel at the beginning, but the light is there. Sometimes all we can do is take the next step — or even just one minute at a time. Keep going. Even when it feels like there is no way forward, there is often a way.

Scar Treatment Can Help Even Years Later

Specialist scar therapy can make a profound difference even many years post-injury (this patient was three years post injury). However, ideally see a scar specialist as soon as possible — ideally while wounds are still healing — to optimise long-term results.

Louise Salter