Burns to the perineum and genitals — management, results and function of the thermally injured perineum in a 5-year-review

Abstract

From 1987From until 1991 patients were treated for partial or full thickness burns of the perineum and genitals. Thirty-seven percent died as an early result of their extended burns. The remainder were analysed with respect to demographics, management, urinary and faecal deviation, operations, infections, anal and urogenital function, and sexual function. This was accomplished by chart study, questionnaires, and physical examination. The results are compared to those published previously. Burns of the perineum and genitals, as such, are not associated with an additional risk for survival. Most of them can be managed conservatively. No dysfunction was seen in the long-term follow-up. However, the quality of life may be affected after a burn trauma.

Outcome of Split Thickness Skin Grafting and Multiple Z-Plasties in Postburn Contractures of Groin and Perineum: A 15-Year Experience

“…Sawhney [ 9 ] reported perineal burns sustained by spilling of kerosene on the clothes from a burning stove or due to explosion of such stoves. Bangma et al [ 5 ] reported burns to the perineum and genitals due to scalds, explosion, open fire, or electricity. Balakrishnan et al [ 7 ] reported perineal burns due to hot water, chemicals, and grease in males secondary to spouse abuse.…”

“…Perineal and genital burns are mostly part of large body surface injuries and isolated burns to perineum and genitalia are uncommon as reported by Abdel-Razek [ 1 ], Peck et al [ 15 ], Bangma et al [ 5 ], and Thakur et al [ 2 ]. In patients with isolated burns to groin and perineum, “Kangri” was the sole causative agent responsible.…”

Management of adult patients with buttock and perineal burns

“…For patients with anal burns, there is some support for the use of a prophylactic ostomy to facilitate wound management and potentially mitigate infectious complications, 4,7,18,19 especially when the burn directly involves the anus. Their use does not seem to affect mortality.…”

“…Fortunately, unless anal sphincter is injured because of the burn, fecal incontinence is unlikely as a result of the burn. 4 For difficult wounds, the creation of a diverting ostomy can result in decreased purulent exudate, healthier granulation tissue, less graft loss, and fewer signs of infection systemically. Thus, if all other attempts have failed to heal a wound, ostomy creation is supported.…”

“…2,19 Although one would consider that diverting stool entirely from the region would decrease that rate of infection, mucosal sloughing from the rectum still seems to provide a source of bacteria. 4,19,20 Timing of Ostomy Reversal Ostomy reversal follows recommendations similar for nonburn patients. Unfortunately, many of these patients have extensive injuries and a protracted course of months to years.…”