Our Experience and Clinical Findings in Perineal Burns: Implications for Patient Prognosis-A 3 Year Retrospective Study

我们在会阴烧伤方面的经验和临床发现:对患者预后的影响——一项为期3年的回顾性研究

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Abstract

Background and Objectives: Burn injury represents a very important public health problem that affects all age groups. Of all burns, of particular interest is that of the perineum. Despite the importance of the subject, unfortunately, the medical literature on this anatomical region is sparse. With this study we aim to analyze the characteristics of burns affecting the perineal area, the physiopathologic implications of this injury, the influence of patient prognosis, possible complications and therapeutic guidelines. Materials and Methods: This study is formed by a retrospective analysis of cases that were admitted over a period spanning 3 years with a total of 258 burned patients. After inclusion criteria, we selected 49 patients who had perineal burns and compared this group to a non-perineal burns lot of 198 patients (11 were excluded). We studied their characteristics and the demographical aspects that we deemed most important to their condition: age, sex, burn percentage of total body surface area (TBSA), the percentage of third-degree lesions, comorbidities, and associated infections, inhalation injuries and we calculated the significant scores such as the Abbreviated Burn Severity Index score (ABSI). Results: The patients in our study mostly had severe extensive burns (64.9% mean TBSA) which were also underlined by the mean ABSI of 10.88 ± 2.46 thus having a poor prognosis considering their age, the percentage of burned area, the presence of third-degree burns and inhalation injuries. In our study, perineal burns were usually associated with burns of adjacent regions abdominal wall burns comprising 51% and thigh burns comprising 97.9% of the associated injuries. This relationship both explains their presence in mostly severe cases with higher TBSA and also underlines the issues that derive from the burns of the perineum and their several complications which lead to an unbalance of the patients. The treatment of perineal burns still remains much debated in the literature when considering their indications and can become rather complex in the sequelae setting. Conclusions: The issue of burns remains one of the most important subjects in plastic surgery. Being a region hard to treat but with a big influence on patient evolution and survival chances prevention remains a key factor.

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