Deep Skin Avulsion

A deep skin avulsion is when all layers of the skin or parts of body structures have been torn away. This is usually a result of severe injury (trauma). A deep skin avulsion can include damage to important structures beneath the skin such as tendons, ligaments, nerves, or blood vessels.


Many injuries can lead to a deep skin avulsion. These include:

  • Crush injuries.

  • Bites.

  • Falls against jagged surfaces.

  • Gunshot wounds.

  • Severe burns and injuries involving dragging (such as those from a bicycle or motorcycle accident).


  • If the wound is small and there is no damage to vital structures like nerves and blood vessels, the damaged tissues may be removed. Then, the wound can be cleaned thoroughly and closed.

  • A skin graft may be performed. This is a procedure in which the outer layer of skin is removed from a different part of your body. That skin (skin graft) is used to cover the open wound. This can happen after damaged tissue is removed and repairs are completed.

  • Your caregiver may only apply a bandage (dressing) to the wound. The wound will be kept clean and allowed to heal. Healing can take weeks or months and usually leaves a large scar. This type of treatment is only done if your caregiver feels that skin grafting or a similar procedure would not work.

You might need a tetanus shot if:

  • You cannot remember when you had your last tetanus shot.

  • You have never had a tetanus shot.

  • The injury broke your skin.

If you got a tetanus shot, your arm may swell, get red, and feel warm to the touch. This is common and not a problem. If you need a tetanus shot and you choose not to have one, there is a rare chance of getting tetanus. Sickness from tetanus can be serious.


  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Gently wash the area with mild soap and water 2 times a day, or as directed. Rinse off the soap. Pat the area dry with a clean towel. Do not rub the wound. This may cause bleeding.

  • Follow your caregiver's instructions for how often you need to change the dressing.

  • Apply ointment and a dressing to the wound as directed.

  • If the dressing sticks, moisten it with soapy water and gently remove it.

  • Change the bandage right away if it becomes wet, dirty, or starts to smell bad.

  • Take showers. Do not take tub baths, swim, or do anything that may soak the wound until it is healed.

  • Use anti-itch medicine as directed by your caregiver. The wound may itch when it is healing. Do not pick or scratch at the wound.

  • Follow up with your caregiver for stitches (sutures), staple, or skin adhesive strip removal.


  • You have redness, swelling, or increasing pain in your wound.

  • A red streak or line extends away from the wound.

  • You have pus coming from the wound.

  • You notice a bad smell coming from the wound or dressing.

  • The wound breaks open (edges not staying together) after sutures have been removed.

  • You notice something coming out of the wound, such as a small piece of wood, glass, or metal.

  • You are unable to properly move a finger or toe if the wound is on your hand or foot.

  • You have severe swelling around the wound that causes pain and numbness.

  • Your arm, hand, leg, or foot changes color.


  • Your pain becomes severe or is not adequately relieved with pain medicine.

  • You have a fever.

  • You have nausea and vomiting for more than 24 hours.

  • You feel lightheaded, weak, or faint.

  • You develop chest pain or difficulty breathing.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.