Editing Lower Urinary Tract Trauma (section)

=== Genital skin loss ===
* '''Most common cause of extensive genital skin loss: necrotizing gangrene secondary to polymicrobial infection in the genital area, or Fournier gangrene'''
* '''In patients with extensive genital skin loss or injury from infection, shearing injuries, or burns (thermal, chemical, electrical), perform exploration and limited debridement of non-viable tissue'''
** Genital skin is well vascularized and tissues with marginal viability may survive due to collateral blood flow.
** Typically, these injuries require multiple procedures in the operating room prior to definitive reconstructive procedures.
** Wound management can include a variety of methods including gauze dressings with frequent changes, silver sulfadiazine or topical antibiotic and occlusive dressing, or negative pressure dressings.
** '''If a urethral catheter is used in a genitalia burn, it should be removed after 72 hours to prevent urethral slough and fistula formation'''
** Reconstructive techniques for definitive repair include primary closure and advancement flaps, placement of skin grafts, free tissue flaps, and pedicle based skin flaps