Delayed full-thickness autografting of cryopreserved avulsed skin in degloving injuries of the extremities

To our knowledge, this is the first experience in the management of degloving injuries using cryopreservation of the degloved skin and a new clinical application of cryobiology and skin autobanking. This procedure may have several advantages over previous procedures in proper indications for several reasons: 1. Surgical time for excising the degloved flap is short. 2. The graft is prepared in a surgical field apart from the patient, who simultaneously undergoes resuscitation, debridement, fracture treatment, etc. 3. The procedure has open wound management and safe control of infection, and it allows second-look debridement. The skin can be cryopreserved under sterile conditions. 4. The early and healthy granulation of muscles offers a smooth, vascularized surface for complete graft take and good aesthetics. 5. Final grafting can be delayed for an unlimited period, until general and local conditions are optimal. 6. Dermal memory around the joints is preserved, including shape and motion creases, and retraction is avoided. 7. The procedure has good aesthetic results, with potential hair bulb survival and hair growth. 8. The patient can be operated on at an institution distant to the tissue bank. Any standard skin bank may receive the surgically prepared piece. The piece of skin can be sent in the collecting solution described at 4°C, and it should be processed no later than 12 hours after being taken from the patient. It can be returned at the surgeon's request, frozen in carbonic ice at -80°C.