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

Abstract

Background. Groin and perineal burn contracture is a rare postburn sequel. Such postburn contractures causes distressing symptoms to the patients and in the management of these contractures, both functional and cosmetic appearance should be the primary concern. Aims. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postburn contractures of groin and perineum. Material and Methods. We conducted a study of 49 patients, with postburn groin and perineal contractures. Release of contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results. Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the contracture in 4 (8.16%) patients required secondary surgery. Conclusion. We conclude that postburn contractures of the groin and perineum can be successfully treated with release of contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary contractures of the graft and recurrence of the contracture.

Skin Grafting in Post burn contractures of Groin and perineum in patients

“…Free tissue transfer with anastomosis around femoral vessels is also an option to reckon with. [20] Also, pertaining to loss of libido or orgasmic dysfunction, it has been noted that 25% of all adult burn patients experience it. [21] Growth is an important variable in the development of perineal contractures in children with burns; thus, these patients should be followed up closely during rapid-growth periods.…”

Managing Thermal Injuries of the Penis and Scrotum: A Narrative Review

“…In this instance, most scars are allowed to mature for one year before correcting the defect using multiple Z-plasties of the medial thigh, perineum and scrotal skin [3,62]. Following Z-plasties, patients have reduced pain, improved comfort, and a broader range of motion [63]. Though less likely, burns can also cause urethral slough and urethral stricture, typically managed by delayed urological reconstruction [64].…”