Burned Perineum: Anatomy of Medial Contracture and Reconstruction with Trapezoid Adipose-Scar Flaps

Abstract

Deep burns of the perineum result in contractures that restrict smooth motion and make personal hygiene difficult. There are two basic contracture types: (1) medial, in which scars form the fold of the perineum; and (2) total, characterized by perineum obliteration. The inelastic scar fold causing tightness and restriction of movement is more easily observed with abducted thighs. The transverse scar fold is formed below or above the genitals. Scar folds, protruding distally, obliterate the perineum. Scars of the perineum make walking and personal hygiene difficult and this indicates surgery. Total contracture, or perineum obliteration, does not have a transverse fold. The fold is scar surface surplus, allowing the medial contracture elimination with local trapezoid flaps. Anatomy and treatment of medial perineal contracture is presented in this chapter.