Run Over By Bus, Here's How A Woman's Legs Were Saved From Amputation

According to a doctor, it is crucial to identify and treat degloving injuries promptly as they can be extremely dangerous. The blood loss is hidden and the tissue damage is much more than what appears from outside.

When she met with a gruesome accident sometime ago, 33-year-old Kinjal Shah's health condition looked grim. She had massive injuries in the lower half of her body and faced the risk of leg amputation. The advertising executive was returning home from work when, while boarding a crowded bus, her hand slipped from the handlebar and she found herself underneath the wheel. While the bus driver promptly stopped and her fellow passengers pulled her out, the bus's wheel had already run over both her legs, following which Shah was rushed to Mumbai's Wockhardt Hospitals, where she was treated by a team led by Dr Shraddha Deshpande, consultant plastic surgeon. The patient suffered from, what is known as, severe degloving injuries.

What are degloving injuries?

Tampa General Hospital defines degloving injuries as traumatic injuries that result in the top layers of skin and tissue being torn away from the underlying muscle, connective tissue or bone. They most commonly affect the legs and are frequently associated with underlying fractures. They typically involve severe blood loss and tissue death, and are often life-threatening. Potential causes include motorcycle accidents, car accidents, sports mishaps, animal bites, a fall from height, construction accidents.

According to tgh.org, when the skin and tissue are "ripped away" and the muscles and bones underneath are exposed, it leads to an open degloving injury. In some cases, the skin may be "partially attached and hanging as a flap near the wound". A closed degloving injury, on the other hand, is more complicated, as the top layer of skin remains intact even though it has been separated from the tissue underneath it.

The case

In this patient's case, she was admitted to the ICU, and after stabilising her, an MRI was done. Severe degloving injury was seen in both her lower limbs. The skin and muscles over her thighs and legs had been completely crushed due to the shearing force; there was also severe blood loss of more than 800 ml.

"The patient was taken in for surgery immediately. The necrotic tissue (dead cell tissue) was removed and specialised negative pressure therapy was administered. Multiple blood transfusions and higher antibiotics were given. The intensive care team managed her effectively while she underwent three surgeries to reconstruct both her lower limbs. The prompt action allowed the patient to recover completely. She was discharged within a month of her accident," said Dr Deshpande.

She added that it is crucial to identify and treat degloving injuries promptly as they can be extremely dangerous. The blood loss is hidden and the tissue damage is much more than what appears from outside. "Such injuries are rare and if not identified in time, can lead to severe infection and sepsis. Utilising advanced wound care and reconstructing the wounds can result in faster recovery, improved functionality, and better outcomes."

The doctor added that the patient has returned to her normal routine and the focus is now on managing her scars and ensuring that she makes a full recovery.