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11-Year Experience in Management of Genital Burns
Mare G. Kaulakis, BS; José A. Arellano, MD; Christopher J. Fedor, MS; Hilary Y. Liu, BS; Garth Elias, MD; Paul J. Rusilko, DO; Alain Corcos, MD; Jenny A. Ziembicki, MD; Francesco M. Egro, MD
University of Pittsburgh Medical Center (UPMC), University of Pittsburgh School of Medicine
2025-01-13
Presenter: Mare G. Kaulakis
Affidavit:
I agree.
Director Name: Francesco M. Egro
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
BACKGROUND: Genital burns pose unique challenges due to their anatomical location, complexity, and infection risk. Treatment protocols vary, highlighting the need for standardized approaches. This study aims to develop a genital burn management algorithm based on an institution's 11-year experience.
METHODS: A retrospective analysis was conducted on genital burn patients at an ABA-verified burn center (2012-2023). Data collected included demographics, burn characteristics, treatment strategies, and outcomes.
RESULTS: The study included 62 patients (69% male, 31% female; mean age 31.13±26.20 years; mean BMI 26.94±12.4). Common comorbidities were hypertension (27.42%; n=17) and smoking (16.13%; n=10). Primary burn etiologies were scald (45.2%; n=28) and flame (38.7%; n=24), with mean %TBSA of 18.04±18.72. Most superficial and superficial-partial thickness burns were managed conservatively (96.55%; n=28), while 51.52% (17 of 33) of deeper burns required surgery.
Common surgical procedures included excision plus split-thickness skin graft (STSG) (35.29%; n=6) and two-stage operations: excision plus cadaveric allograft followed by STSG (29.41%; n=5). The mean number of operations increased with burn depth; full-thickness burns were 60.39 times (p=0.002) more likely to require surgery and 9.78 times (p=0.038) more likely to undergo multiple surgeries compared to superficial genital burns.
17.65% (n=3) of surgical patients experienced graft loss and no patients developed post-burn scar contractures. Average follow-up was 1.99 ± 4.87 months.
CONCLUSION: Deeper genital burns are more likely to require surgical intervention and multiple operations. Based on these findings, an algorithm was developed recommending conservative management for superficial burns and surgical intervention for burns extending beyond the dermis.
