Principles of burn reconstruction: Perineum and genitalia
- Jorge Leon-Villapalos, MD, FRCS
Jorge Leon-Villapalos, MD, FRCS
- Consultant in Plastic Surgery and Burns
- Chelsea and Westminster Hospital, London, UK
- Peter Dziewulski, MD, FRCS
Peter Dziewulski, MD, FRCS
- Consultant in Plastic Surgery and Burns
- St. Andrews Centre for Plastic Surgery and Burns, Essex, UK
Burns to the perineum and genitalia are an uncommon, but devastating, injury . Burns to these areas generally occur in conjunction with burns involving other anatomic sites, but may be isolated as in the cases of intentional scalding [2,3]. Resuscitation and stabilization of the burned patient are the first priorities, followed by management of the burn wounds.
Burns to the perineum and genitalia can potentially impair or destroy function, esthetics, and the ability to maintain proper hygiene. The loss of normal tissue and scarring can result in limitation of movement, pain, disfigurement, and social embarrassment. Surveillance for preservation of genitourinary and sexual function is a component of the treatment plan.
The initial management of burns to the perineum and genitalia and reconstruction of the resultant complicated wounds are discussed here. Local treatment and acute management and an overview of reconstruction principles are reviewed elsewhere. (See "Local treatment of burns: Topical antimicrobial agents and dressings" and "Emergency care of moderate and severe thermal burns in children" and "Principles of burn reconstruction: Overview of surgical procedures" and "Emergency care of moderate and severe thermal burns in adults".)
Burns to the perineum and genitalia occur in approximately 3 to 13 percent of all patients sustaining burns [4,5]. Isolated burns to the perineum and/or genitalia are rare, particularly in females, and are a marker for abuse in children [1,4,6-8]. Isolated burns in children warrant an evaluation for possible child abuse and a clear etiology of the burn should be established (See "Physical child abuse: Recognition", section on 'Intentional burns' and "Physical child abuse: Diagnostic evaluation and management" and "Child abuse: Social and medicolegal issues".)
The global epidemiology of burns is reviewed elsewhere. (See "Epidemiology of burn injuries globally".)
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