A case of complex treatment of deep burns of the buttocks, perineum, genitals, received by an explosion from a firecracker

Abstract

A case of a rare localization of skin lesions by a firecracker flame is described. Burns of II – III degree S 18% of p.t. with lesions of the back, buttocks, perineum, genitals were obtained as a result of illegal actions on the patient. The patient's condition at admission is severe, due to the area and degree of the lesion. Conscious, but intoxicated. Wounds in the perineum, genitals, buttocks, thighs, back are represented by dry white dermis with charring, and on the buttocks – in places with eversion of the subcutaneous tissue. In the area of the vagina, edema and lacerations of the mucous membrane of the labia were observed, at the entrance to the anus there was a hematoma; damage to the rectum and internal genital organs was not revealed. Installed a urinary catheter, the urine is light. In blood tests: leukocytosis, hypoproteinemia, hyperbilirubinemia. Complex treatment included anti-shock, anticoagulant (heparin), antibacterial, analgesic, transfusion therapy (FFP 4750 ml, albumin 10% 800  ml, erythrocyte mass 633 ml), nutritional support (Isosurs). The treatment used a fluidizing bed "Reditron" in the pulse-mode. Bandaging with antiseptics and ointments was regularly performed, staged necrectomies were performed. After preparation of granulating wounds, three stages of autodermoplasty of the above areas were performed on the 30th, 37th, 51st days after the injury. The postoperative period was uneventful. Conservative therapy, physiotherapy, exercise therapy continued. Blood counts returned to normal. Against the background of complex treatment, the patient's skin was completely restored, the functions of the genitals and the anal canal remained.