Genital Burns Research Articles

Management of genital burns: A review

We review the etiology and the management strategy of genital burns. The incidence of genital burns ranges from 2.8 to 13%. Most are part of larger injuries. Scald burns are typical for children, whereas flame and chemical burns happen more often in adults. For first and second-degree genital burns, a conservative approach with physiological dressings and topical antimicrobials is advised. Only third degree burns need to be treated with removal of necrotic tissue and grafting. Indwelling catheters or suprapubic drainage systems must be avoided whenever possible.

The significance of recent changes noted in genital burns in children

The significance of recent changes noted in genital burns in children

Prevention of testicular ultrastructural damage in genital burns with burnshield ® application

Prevention of testicular ultrastructural damage in genital burns with burnshield ® application

Unusual Genital Burn Caused by Paraquat-Two Case Reports

Paraquat is used as a herbicide in agriculture. Although Paraquat intoxication was frequently reported in Asian society in accidental ingestion or suicidal attempt, irritation to skin by paraquat was only sporadically described. As for severe dermal damage due to contact, there was rare literature published. Two farmers with 2(superscript nd) degree burn, 3% and 2 % TBSA, respectively in the perineal areas due to accidental contacting with paraquat were reported. Tracing back the history, leakage of the paraquat solution from the defective spraying equipment and wearing of old plastic working pants contributed to this specific burn in perineal site. Both patients received topic silver sulfadiazine ointment for wound care. Most of the wounds healed smoothly but some burn areas needed debridement due to deeper dermal injury. Eventually, these wounds healed without any sequela.

Long term functional outcomes and quality of life following severe burn injury

This study was designed to examine functional and psychological outcome of severely burned patients adults. Adult patients (n = 38) admitted to the Royal Brisbane hospital with burns >40% TBSA were assessed two years post injury using the Abbreviated BSHS and a supplemental questionnaire relating to specific physiotherapy and occupational health issues. An average return to driving occurred at 36 weeks and return to work at 51 weeks. Involvement of the hands and face significantly altered the physical domain of the questionnaire and the sub-domain examining role. Genital burns altered the sexual sub-domain, but this was not gender dependant. Mobility and self care were significantly altered when a burn was >20% TBSA full thickness. The study demonstrates that these patients can develop functional independence and good quality of life. The long term outlook for patients with large burns is generally positive. Consequently, bum care professionals can be reassured that the effort is worthwhile.

Genital burns from home use of podophyllin

A 50-year-old male, without any significant past medical history, presented to the Emergency Department (ED) with complaint of scrotal burns. The patient was seen in clinic 1 week prior to the ED visit and given a topical treatment for genital warts. The preparation was a 25% suspension of podophyllin in benzoin. The patient applied the solution once daily for 3 days by using the dropper that came with the bottle. The patient had difficulty containing the solution when applying it to the affected area and the solution would often spread over his scrotal area and upper legs. The patient first noticed the burns 5 days after the first application of podophyllin (2 days following discontinuation of use). Physical exam revealed an apparently healthy male. Vital signs were blood pressure 150/100, heart rate 117, respiratory rate 16, and temperature 36.8 C. His HEENT, heart, and lung exam were unremarkable. His genitourinary exam revealed partial thickness burns to his penis, scrotum and upper legs with near total skin denudation (Fig. 1). He also had bilateral inguinal lymphadenopathy. The following are his laboratory values: WBC 5900 hemoglobin 17.2 g, platelets 292,000, sodium 139 meq./L, potassium 4.2 meq./ L, chloride 102 meq./L, bicarbonate 29 BUN 8 mg/dL, creatinine 1.0 mg/dL glucose 79 mg/dL AST 20 IU/L, ALT 19IU/L, PT 10.7 INR 1.0 PTT 27.6. The patient was evaluated by the burn team and discharged home with local wound care.

Genital and perineal burns in children: 10 years of experience at a major burn center

Purpose: The aim of this report is to review a decade of experience in the management of perineal and genital burns at a major burn center. Methods: Seventy-eight children who sustained perineal or genital burns admitted to the Shriners Hospitals for Children in Galveston are discussed. Results: Genital and perineal burns occurred in the context of major burns and were rarely isolated. A total of 64.1% were caused by hot liquids (scalds), 29.5% were flame burns, 3.8% contact burns, and 2.6% electrical burns. A total of 61% of the burns could be treated conservatively with loose debridement, topical, and parenteral antibiotics with satisfactory outcomes. Foley catheterization did not increase the morbidity in these patients except in children less than 1 year of age. Testicular involvement was associated with the most severe burns. Child abuse was found in 46% and 48% of boys and girls, respectively, younger than 2 years that had sustained scald burns to the perineum and, or genitals. Conclusions: Most perineal and genital burns in children can be treated successfully with a conservative approach. Child abuse should be vigorously investigated. J Pediatr Surg 37:99-103. Copyright © 2002 by W.B. Saunders Company.

Squamous cell carcinoma arising at the base of the penis in a burn scar

Squamous cell carcinoma developed after 32 years in a burn scar located on the ventral surface of the penis at the penoscrotal junction. The origin of squamous cell carcinoma in burn scars is a rare and not completely understood phenomenon. To the best of our knowledge, this is the first documented case of such an event in the penis because of the extreme rarity of genital burns.

BURNS TO THE GENITALIA AND THE PERINEUM

Purpose We conducted a study to determine the treatment of perineal and genital burns, the results of therapy and the complications of such burns. Materials and Methods A review of the records of 4,216 patients treated between 1981 and 1995 at the Burn Center of the Academic Surgical Center Stuivenberg, revealed 87 male and 30 female patients, 6 months to 86 years old who had associated burns to the perineum or genitalia. Mean burn size was 21% of the total body surface area. Causes of burn injury were scald in 55% of the cases, flame in 24%, chemical in 16% and others in 4%. Results There were 16 deaths in this group (13.6%) but none was related to the perineal or genital burns. Of the 101 survivors 41% required Foley catheters but the catheters were indwelling during resuscitation only (range 1 to 99 days). Perineal and genital burns were treated by topical antimicrobials. Only 10 patients (9.9%) required split-thickness skin grafts. As late complication 2 patients had scar formation of the penile shaft, which was treated with multiple Z-plasties, and of the prepuce, which was treated by circumcision, respectively. In 1 patient, who presented with erectile dysfunction diagnostic evaluation was negative. Conclusions Conservative management of perineal and genital burns is recommended.

Burns to the genitals and the perineum in children.

To determine the management of perineal and genital burns in children. Twenty-seven children (aged 6 months to 12 years) suffering from genital or perineal burns between 1981 and 1995 were reviewed. Most burns occurred in boys (70%), were due to scalds (85%) and caused superficial second-degree lesions (63%). The initial treatment consisted of topical antimicrobials or grafting with allografts. Spontaneous healing by conservative therapy, not early excision therapy, occurred in 96% of the patients. Contractures occurred in two patients and were treated with multiple Z-plasties and circumcision. The management of perineal and genital burns in children should be conservative.

Management of Pediatric Perineal and Genital Burns: Twenty-Year Review

Between 1966 and 1986, fifty-seven pediatric patients with partial and/or full-thickness perineal and genital burns with a minimum of 1-year follow-up were identified. Fifty percent of the patients with genital burns and 20% of the patients with perineal and/or buttock burns required skin grafting in the acute stage. No patient required suprapubic cystostomies, diverting colostomies, or local flap coverage of exposed testicles. Burn scar contractures were the most frequent complications. Thirty-two patients (56%) required contracture release of the perineum and coverage with either skin grafts or local skin flaps. In three patients (6%) contracture required release of the penis and scrotum. One patient lost a testicle. Three patients developed rectal prolapse and were treated without surgery. Four patients developed rectal stenosis with fecal incontinence because of burn scar contracture and were treated by anal dilatation, local transposition flaps, and/or excision of the scar and primary closure. Acute management of pediatric patients with such injuries can be conservative. Delayed complications of contractures of the perineum and genitals can be easily corrected with scar excisions, skin grafts, or the use of local skin flaps.

The Management of Burns to the Perineum and Genitals

A review of 1987 patients treated during the years 1981 to 1986 was conducted to answer the following questions about perineal burns: (1) Are Foley catheters necessary for all patients? (2) Is there any advantage to early excision of the perineal burn wound? (3) What are the complications of perineal wounds? One hundred three patients with perineal burns were identified; mean burn size was 36% of total body surface area. There were 29 deaths in this group but none were related to the perineal burns. Of the 74 survivors 36 (49%) needed Foley catheters. However, the catheters were in place for the period of resuscitation only. There were no urethral complications associated with catheterization. Only three patients required surgery: one had a urethral meatotomy and two had split-thickness skin grafts. In conclusion, we found no genitourinary complications associated with perineal burns. Almost all perineal and genital burns were managed without indwelling catheters. Early excision of the perineal burn wound is not necessary, and most of these wounds will heal satisfactorily without grafting.