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.