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

Wani Sajad,Raashid Hamid

doi:10.1155/2014/358526

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.

Highlights

Perineum and groin constitute only 4–6% of total body surface area and are very important sites in the body anatomically and functionally
25 (51.02%) patients had isolated burns of groin and perineum and, in 24 (48.98%) patients, burns to groin and perineum were associated with burns to surrounding areas including external genitalia, lower abdomen, and upper thighs
External genitalia were hidden under the web in 21 (42.85%) patients having bilateral groin contractures associated with contractures of the surrounding areas

Summary

Introduction

Perineum and groin constitute only 4–6% of total body surface area and are very important sites in the body anatomically and functionally. Isolated burns to the genitalia and perineum are not common [1,2,3] These burns are of major concern to the patient as well as clinician [4]. 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. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postburn contractures of groin and perineum. 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

Methods

Results

Conclusion