Alghanem A A, McCauley R L, Robson M C, Rutan R L, Herndon D N
Division of Plastic Surgery, University of Texas Medical Branch, Galveston.
J Burn Care Rehabil. 1990 Jul-Aug;11(4):308-11. doi: 10.1097/00004630-199007000-00007.
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.
1966年至1986年间，共确定了57例患有部分和/或全层会阴及生殖器烧伤的儿科患者，并对其进行了至少1年的随访。50%的生殖器烧伤患者和20%的会阴及/或臀部烧伤患者在急性期需要植皮。没有患者需要耻骨上膀胱造瘘术、转流性结肠造口术或局部皮瓣覆盖暴露的睾丸。烧伤瘢痕挛缩是最常见的并发症。32例患者（56%）需要会阴挛缩松解术，并采用植皮或局部皮瓣覆盖。3例患者（6%）挛缩需要阴茎和阴囊松解。1例患者睾丸丢失。3例患者出现直肠脱垂，未经手术治疗。4例患者因烧伤瘢痕挛缩出现直肠狭窄并伴有大便失禁，通过肛门扩张、局部转位皮瓣和/或瘢痕切除及一期缝合进行治疗。此类损伤的儿科患者的急性期处理可以是保守的。会阴和生殖器挛缩的延迟并发症可以通过瘢痕切除、植皮或使用局部皮瓣轻松纠正。
