Management of burn contractures of the perineum

Burns of the perineum are rare but very disabling. The author's experience in managing six such cases, 3 males and 3 females, age 8 to 17 years, is discussed. These burns occurred following overspilling of kerosene onto trousers while lighting a stove or as a result of a stove explosion. The treatment is aimed at release of the scar contracture and restoration of genitals to their normal position. An attempt is made to provide full-thickness skin cover in front of pubis by wide undermining of lower abdominal skin and advancing it downward. If, however, the abdomen is scarred, the whole of the resultant raw area is covered with thick split-skin graft. Graft contracture is prevented by advising tightly fitting underwear incorporating a wide elastic band sited over the inguinal furrow between the thighs and perineum.