Improvement of survival in patients with extensive burns involving the perineum with use of a faecal management system

The purpose of this study is to assess the effectiveness of faecal management systems in improving survival of patients with extensive burns involving the perineum. All adults with burns of more than 30% total body surface area (TBSA) who were actively treated in our regional burn service between December 2008 and July 2012 were reviewed and compared to an historical cohort of 18 adult patients with similar injury involving the perineum, treated in our regional burn service between 1999 and 2001. For the last five years, faecal management systems (FMS) have been in use for patients with extensive burns involving the perineum. Sixteen patients with burns greater than 30% TBSA involving the perineal region were admitted during this period and all were managed with FMS. Four of the 16 patients (25%) managed with FMS died compared to 11 of the 18 patients (61%) in the historical cohort. The survival of patients with extensive burns involving the perineal region was improved using FMS. No significant complications were reported in relation to the use of FMS. FMS allows faecal diversion, reduced perineal soiling and improved personal hygiene. We believe this allows easier management of these difficult injuries, may reduce the incidence of sepsis and improves survival.