title: Modified classification and repair of perineal soft tissue injuries associated with open pelvic fractures.
abstract: BACKGROUND
  This study describes a modified classification and management protocol for perineal soft tissue injuries associated with pelvic fractures.
  
  
  METHODS
  A total of 11 patients with perineal soft tissue injuries associated with open pelvic fractures were studied retrospectively. The patients were classified into three types based on the area of defect: type A (urogenital zone), type B (anal zone), and type C (both urogenital and anal zones). Each type included the following subclasses: A1 (without urethra injuries), A2 (with urethra injuries), B1 (without anorectal injuries), B2 (with anorectal injuries), C1 (with types A1 and B1), C2 (with types A2 and B1), C3 (with types A1 and B2), and C4 (with types A2 and B2). The management protocol was planned according to the individual classifications. Protocol A1 (for type A1) involved skin graft or myocutaneous flap transplantation. Protocol A2 (for type A2) involved the same protocol combined with urine diversion. Protocol B1 (for type B1) involved skin graft or myocutaneous flap transplantation. Protocol B2 (for type B2) involved the same management combined with fecal diversion. Protocol C involved the correspondent protocol used for each subtype of type C.
  
  
  RESULTS
  Out of the 11 patients, there were 5, 3, and 3 cases of types A, B, and C, respectively. One patient died due to sepsis, and the wounds of the remaining patients healed well. No anal incontinence had occurred.
  
  
  CONCLUSIONS
  Perineal soft tissue injuries associated with pelvic fractures can be classified into three types, and the management protocol can be planned according to the classification.
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Guo
authors.initials: G
authors.lastname: Fu
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Bengang
authors.initials: B
authors.lastname: Qin
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qi
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Qingtang
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jiakai
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Microsurgery and Trauma Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Li-Qiang
authors.initials: LQ
authors.lastname: Gu
mesh_terms: D002681:China; D002985:Clinical Protocols; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D005597:Fractures, Open / Q000145:classification / Q000150:complications / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D010502:Perineum / Q000293:injuries* / Q000601:surgery; D012007:Rectum / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000145:classification / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing