fig4

Figure 4. (A, B) A complex circumferential degloving injury with gross contamination after a motor vehicle collision; (C) An external fixator was placed to stabilize the carpus and the volar soft tissue deficit was reconstructed with a pedicled groin flap; (D) The dorsal soft tissue deficit was addressed with placement of a dermal regeneration matrix; (E, F) 3 weeks later, the groin flap was divided and inset, and split-thickness skin grafting was performed on the dorsum of the hand.