Tensor Fascia Lata (TFL) Muscle Flap Associated With a Skin Graft, as a Salvage Solution in Deep Abdomino-Perineal and External Genitalia Burns

Abstract

A burn corresponds to a destruction of the skin and/or deep subcutaneous structures caused by a thermal, electrical or chemical agent. When it is deep, it poses the problem of reaching the underlying noble structures. Burning by hot contact in the context of an epileptic seizure, starting from the mutilations they cause, often requires the use of shreds to cover the losses of the substances generated. It causes significant morbidity and mortality, hence the importance of urgent and adequate initial management. The abdomino-perineal region and the external genitalia (EG) are rarely affected. We report a case of deep burn of the abdomino- perineal region and EG occurring in the context of a work accident in which the exposure of underlying noble elements required the use of Tensor Fascia Lata (TFL) muscle Flap. It was a 31-year-old man, chronic smoker at 10 PA and epileptic for 8 years, having stopped his treatment, who was admitted to hour 2 (H2) for his burn by hot contact which occurred following an epileptic attack. The patient had fallen on a hot welding instrument in the context of an informal work accident. Initially transferred to a local hospital, he was sent to us for care. Examination found a 3rd degree burn affecting the abdomino - inguino -pubic regions, the sheath of the penis and the scrotum. The initial management consisted of hemodynamic stabilization, the realization of a relief incision at the level of the sheath of the penis and local care. An early excision of abdomino-perineal on day 3 had been performed having exposed the spermatic cords, followed by coverage on day 10 by a Tensor Fascia Lata muscle Flap of the inguinal region - pubis, split – thickness skin graft of the sheath of the penis. The postoperative course was simple.